Provider Demographics
NPI:1912944877
Name:FOLSOM, KENT R (MD)
Entity Type:Individual
Prefix:DR
First Name:KENT
Middle Name:R
Last Name:FOLSOM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1515 CUMBERLAND DR
Mailing Address - Street 2:
Mailing Address - City:ROCKINGHAM
Mailing Address - State:VA
Mailing Address - Zip Code:22801-8000
Mailing Address - Country:US
Mailing Address - Phone:540-820-6801
Mailing Address - Fax:
Practice Address - Street 1:2010 HEALTH CAMPUS DR
Practice Address - Street 2:
Practice Address - City:ROCKINGHAM
Practice Address - State:VA
Practice Address - Zip Code:22801-8679
Practice Address - Country:US
Practice Address - Phone:540-689-1414
Practice Address - Fax:540-689-1415
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-01
Last Update Date:2021-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101051827207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA6021697Medicaid
VA0046176000OtherWEST VA MEDICAID
VA930027681OtherRAILROAD MEDICARE