Provider Demographics
NPI:1760460141
Name:FOLTZ, DOUGLAS S (DPM)
Entity type:Individual
Prefix:DR
First Name:DOUGLAS
Middle Name:S
Last Name:FOLTZ
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 801143
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64180-1143
Mailing Address - Country:US
Mailing Address - Phone:573-331-3000
Mailing Address - Fax:573-331-5073
Practice Address - Street 1:1012 N MAIN ST
Practice Address - Street 2:
Practice Address - City:SIKESTON
Practice Address - State:MO
Practice Address - Zip Code:63801-5044
Practice Address - Country:US
Practice Address - Phone:573-431-0330
Practice Address - Fax:573-471-0461
Is Sole Proprietor?:No
Enumeration Date:2006-01-05
Last Update Date:2021-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2003030830213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO430741410OtherFIRST HEALTH NUMBER
MO191447OtherBCBS MO NUMBER
MO670379OtherHEALTHLINK
MO43074141063801A012OtherTRICARE