Provider Demographics
NPI:1356600159
Name:FOLLEY, AUSTIN T (MD)
Entity type:Individual
Prefix:DR
First Name:AUSTIN
Middle Name:T
Last Name:FOLLEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:AUSTIN
Other - Middle Name:TAYLOR
Other - Last Name:FOLLEY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:300 W HOSPITAL RD
Mailing Address - Street 2:
Mailing Address - City:FORT GORDON
Mailing Address - State:GA
Mailing Address - Zip Code:30905-5741
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3315 S ALAMEDA ST
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78411-1820
Practice Address - Country:US
Practice Address - Phone:361-761-1400
Practice Address - Fax:361-857-5960
Is Sole Proprietor?:No
Enumeration Date:2012-05-14
Last Update Date:2019-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101255619207P00000X
TXS1806207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAVAD 000Medicare UPIN