Charles Kenneth Foulsham II, MD

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

License

MD026474E Issued in PA

Practice address

401 High Street
Lock Haven, PA 11774-0117

Phone

(570) 748-6777

Fax

(570) 748-0110

NPI assigned

Dec 28, 2006

Last updated

Nov 11, 2008By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Lock Haven Ear Nose & Throat PC

  • Otolaryngology Physician
  • Lock Haven, PA
  • NPI 1346396363
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1167264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1226361600000",
    "number": "1972669612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 117",
            "city": "LOCK HAVEN",
            "state": "PA",
            "postal_code": "177450117",
            "telephone_number": "570-748-6777",
            "fax_number": "570-748-0110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 HIGH STREET",
            "city": "LOCK HAVEN",
            "state": "PA",
            "postal_code": "117740117",
            "telephone_number": "570-748-6777",
            "fax_number": "570-748-0110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOULSHAM",
        "first_name": "CHARLES",
        "middle_name": "KENNETH",
        "name_prefix": "Dr.",
        "name_suffix": "II",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-28",
        "last_updated": "2008-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "PA",
            "license": "MD026474E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0008614940001",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GEISINGER HEALTH PLAN",
            "identifier": "18639",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "058467",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Family Practice Center, PC
• Jennifer Fithian, LCSW
• Ashley Renee Foltz, PA-C
• Amiyah Monique Ford
• William R. Forse, OD
• Carrie Friese, PA-C
• Boris Gabinskiy, M.D.
• Kyle Hoyt Galer, LCSW
• Laura Michelle Gardner, M.S.
• Lily Ann Gardner

• Otolaryngology Physician in Lock Haven, PA
• Providers in Lock Haven, PA by specialty
• Otolaryngology Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.