Provider Demographics
NPI:1780785733
Name:FOLWELL, BYRON R (DC)
Entity type:Individual
Prefix:DR
First Name:BYRON
Middle Name:R
Last Name:FOLWELL
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3211 EMERSON AVE
Mailing Address - Street 2:
Mailing Address - City:PARKERSBURG
Mailing Address - State:WV
Mailing Address - Zip Code:26104-1715
Mailing Address - Country:US
Mailing Address - Phone:304-485-9124
Mailing Address - Fax:304-485-9127
Practice Address - Street 1:3211 EMERSON AVE
Practice Address - Street 2:
Practice Address - City:PARKERSBURG
Practice Address - State:WV
Practice Address - Zip Code:26104-1715
Practice Address - Country:US
Practice Address - Phone:304-485-9124
Practice Address - Fax:304-485-9127
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-25
Last Update Date:2024-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV510171100000X, 204R00000X, 111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No171100000XOther Service ProvidersAcupuncturist
No204R00000XAllopathic & Osteopathic PhysiciansElectrodiagnostic Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA001710854OtherBLUE CROSS/BLUE SHIELD
WV0131769000Medicaid
WV0131769000Medicaid
U28599Medicare UPIN