Basic Information
Provider Information
NPI: 1356600159
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: FOLLEY
FirstName: AUSTIN
MiddleName: T
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: FOLLEY
OtherFirstName: AUSTIN
OtherMiddleName: TAYLOR
OtherNamePrefix: DR.
OtherNameSuffix:  
OtherCredential: MD
OtherLastNameType: 5
Mailing Information
Address1: 300 W HOSPITAL RD
Address2:  
City: FORT GORDON
State: GA
PostalCode: 309055741
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 3315 S ALAMEDA ST
Address2:  
City: CORPUS CHRISTI
State: TX
PostalCode: 784111820
CountryCode: US
TelephoneNumber: 3617611400
FaxNumber: 3618575960
Other Information
ProviderEnumerationDate: 05/14/2012
LastUpdateDate: 07/11/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207P00000X0101255619VAN Allopathic & Osteopathic PhysiciansEmergency Medicine 
207P00000XS1806TXY Allopathic & Osteopathic PhysiciansEmergency Medicine 

No ID Information.


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