Individual
CLARENCE E. FOGLEMAN III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
111 E POLK ST, COLORADO SPRINGS, CO 80907-6267
(719) 473-8801
(719) 473-8581
Mailing address
111 E POLK ST, COLORADO SPRINGS, CO 80907-6267
(719) 473-8801
(719) 473-8581
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
27918
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
020006928
RR MEDICARE
—
05
—
1279181
—
CO
01
—
FO30141
BLUE SHIELD
CO
Enumeration date
07/18/2006
Last updated
08/10/2012
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