Provider Demographics
NPI:1245262591
Name:FOULK, BRIAN R (MD)
Entity type:Individual
Prefix:
First Name:BRIAN
Middle Name:R
Last Name:FOULK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 716
Mailing Address - Street 2:100 SHENANGO AVENUE
Mailing Address - City:SHARON
Mailing Address - State:PA
Mailing Address - Zip Code:16146-0716
Mailing Address - Country:US
Mailing Address - Phone:814-743-5449
Mailing Address - Fax:814-743-6293
Practice Address - Street 1:1555 SHAWNA RD
Practice Address - Street 2:
Practice Address - City:CHERRY TREE
Practice Address - State:PA
Practice Address - Zip Code:15724-9003
Practice Address - Country:US
Practice Address - Phone:814-743-5449
Practice Address - Fax:814-743-6293
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2013-12-11
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAMD427071207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine