Rebecca Ann Foulk, MD

Individual provider Active NPI Pediatrics Physician · South Royalton, VT

NPI 1154353274 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1154353274
Entity type
Individual (NPI type 1)
Primary specialty
Pediatrics Physician 208000000X
License
042-0006862 (VT)
Practice address
79 South Windsor St
South Royalton, VT 05068
Phone
(802) 763-7575
Fax
(802) 763-2190
NPI assigned
Jul 7, 2006
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
042-0006862VTMDPediatrics Physician

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 042-0006862 VT Yes

Addresses

Primary practice location

79 South Windsor St
South Royalton, VT 05068

Mailing address

PO Box 119
South Royalton Health Center
South Royalton, VT 05068
Phone (802) 763-7575

Other identifiers

IdentifierTypeStateIssuer
0005851MedicaidVT
5851OtherVTBCBS VT

Other providers in South Royalton, VT

All providers in South Royalton, VT · Pediatrics Physician in Vermont

Sources for this page

Verify at the official NPI Registry.