Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RE0101X | Endocrinologist (Diabetes Doctor) | 01072641A | IN |
N | 207RE0101X | Endocrinologist (Diabetes Doctor) | 50222 | KY |
N | 2080P0205X | Pediatric Endocrinologist | 01072641A | IN |
Y | 2080P0205X | Pediatric Endocrinologist | 50222 | KY |
NPI | 1215165675 |
---|---|
Provider Name | Dr. Lisal J Folsom |
First Address | Louisville, KY 40201-0909 |
Second Address | Louisville, KY 40202-1837 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/06/2009 |
Last Update Date | 26/01/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
300005281 | (05) | IN |
7100457040 | (05) | KY |