Basic Information
| Provider Information | |||||||||
| NPI: | 1851359673 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | FOLTZ | ||||||||
| FirstName: | JAMES | ||||||||
| MiddleName: | WALTER | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3811 E BELL RD | ||||||||
| Address2: | STE 312 | ||||||||
| City: | PHOENIX | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 850322160 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6028672505 | ||||||||
| FaxNumber: | 6024041499 | ||||||||
| Practice Location | |||||||||
| Address1: | 3811 E BELL RD | ||||||||
| Address2: | STE 312 | ||||||||
| City: | PHOENIX | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 850322160 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6028672505 | ||||||||
| FaxNumber: | 6024041499 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/02/2006 | ||||||||
| LastUpdateDate: | 10/03/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207VX0000X | 12263 | AZ | Y | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | Obstetrics |
ID Information
| ID | Type | State | Issuer | Description | 229395 | 05 | AZ | MEDICAID |