Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 58351 | TN |
N | 207X00000X | Orthopaedic Surgeon | T-2796 | MS |
N | 208200000X | Surgeon | LL35780 | SC |
N | 208600000X | Surgeon | LL35780 | SC |
NPI | 1023456720 |
---|---|
Provider Name | Jacob M Folse |
First Address | Jackson, MS 39216-4500 |
Second Address | Jackson, MS 39216-4500 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/06/2013 |
Last Update Date | 08/07/2019 |