Provider Demographics
NPI:1659240695
Name:FOLSON, JEROMIE TODD
Entity type:Individual
Prefix:
First Name:JEROMIE
Middle Name:TODD
Last Name:FOLSON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13865 HOMER LN
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:GA
Mailing Address - Zip Code:30014-2359
Mailing Address - Country:US
Mailing Address - Phone:470-782-1176
Mailing Address - Fax:
Practice Address - Street 1:13865 HOMER LN
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:GA
Practice Address - Zip Code:30014-2359
Practice Address - Country:US
Practice Address - Phone:470-782-1176
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-10-29
Last Update Date:2025-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator