Provider Demographics
NPI:1891825279
Name:FOLGAR, ROSA DESHA (MD)
Entity Type:Individual
Prefix:DR
First Name:ROSA
Middle Name:DESHA
Last Name:FOLGAR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:LSU STUDENT HEALTH CTR
Mailing Address - Street 2:INFIRMARY ROAD
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70803-0001
Mailing Address - Country:US
Mailing Address - Phone:225-578-6271
Mailing Address - Fax:225-578-0596
Practice Address - Street 1:LSU STUDENT HEALTH CTR
Practice Address - Street 2:INFIRMARY ROAD
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70803-0001
Practice Address - Country:US
Practice Address - Phone:225-578-6271
Practice Address - Fax:225-578-0596
Is Sole Proprietor?:No
Enumeration Date:2007-03-06
Last Update Date:2016-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMD 200256207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1073741Medicaid
LA4K683DX80Medicare PIN