Provider Demographics
NPI:1962498964
Name:FOLARIN, VICTOR A (MD)
Entity Type:Individual
Prefix:DR
First Name:VICTOR
Middle Name:A
Last Name:FOLARIN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:2841 N PATTERSON ST
Mailing Address - Street 2:NF/SG VAHS VALDOSTA OUTPATIENT CLINIC
Mailing Address - City:VALDOSTA
Mailing Address - State:GA
Mailing Address - Zip Code:31602-1890
Mailing Address - Country:US
Mailing Address - Phone:229-293-0132
Mailing Address - Fax:229-293-0162
Practice Address - Street 1:2841 N PATTERSON ST
Practice Address - Street 2:NF/SG VAHS VALDOSTA OUTPATIENT CLINIC
Practice Address - City:VALDOSTA
Practice Address - State:GA
Practice Address - Zip Code:31602-1890
Practice Address - Country:US
Practice Address - Phone:229-293-0132
Practice Address - Fax:229-293-0162
Is Sole Proprietor?:No
Enumeration Date:2005-09-25
Last Update Date:2014-02-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KY25135207Q00000X, 2083A0100X, 2083P0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No2083A0100XAllopathic & Osteopathic PhysiciansPreventive MedicineAerospace Medicine
No2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY25135OtherMEDICAL LICENSE