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Individual

BENJAMIN PERRY FOLK III

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1502 S COLORADO ST, GREENVILLE, MS 38703-7219
(662) 332-9872
(662) 378-0290
Mailing address
1502 S COLORADO ST, GREENVILLE, MS 38703-7219
(662) 332-9872
(662) 378-0290

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
10931
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0016500
MS
01
060024546
RR MEDICARE
MS
01
112656001
AR MEDICAID
MS
01
4376234
AETNA PIN
MS
Enumeration date
06/12/2006
Last updated
01/03/2020
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