Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | 01048787 | IN |
N | 2081P2900X | Pain Medicine | 01048787 | IN |
NPI | 1073577078 |
---|---|
Provider Name | Brian Foley |
First Address | Indianapolis, IN 46250-2805 |
Second Address | Indianapolis, IN 46256 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/04/2006 |
Last Update Date | 24/09/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000526519 | ANTHEM (01) | IN |
200236570 | (05) | IN |
5970657 | AETNA (01) | IN |
G93291 | (02) | IN |
P01157036 | MEDICARE RR (01) | IN |