Provider Demographics
NPI:1881013647
Name:FOLZ, JOSEPH (DO)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:
Last Name:FOLZ
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 21890
Mailing Address - Street 2:
Mailing Address - City:BELFAST
Mailing Address - State:ME
Mailing Address - Zip Code:04915-4115
Mailing Address - Country:US
Mailing Address - Phone:502-907-0356
Mailing Address - Fax:502-919-9780
Practice Address - Street 1:700 KIMBER LANE
Practice Address - Street 2:
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47715
Practice Address - Country:US
Practice Address - Phone:812-476-7111
Practice Address - Fax:812-476-7117
Is Sole Proprietor?:No
Enumeration Date:2014-04-09
Last Update Date:2022-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY04506208VP0000X
IN02005642A208VP0000X
IL036149269208VP0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CS1916100305OtherCARESOURCE PROVIDER ID NUMBER
KYPDZ000000259409OtherAETNA BETTER HEALTH OF KY PROVIDER ID NUMBER
IN300024375Medicaid
6674915OtherAETNA PROVIDER ID NUMBER
000001269795OtherANTHEM PROVIDER ID NUMBER
IL036149269Medicaid
7056875OtherUNITED HEALTHCARE PROVIDER ID NUMBER
KY7100591270Medicaid
KY1970185OtherWELLCARE OF KY PROVIDER ID NUMBER