Organization
FOGGY BOTTOM PRIMARY CARE PHYSICIANS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TODD EVANS (VP)
(610) 382-4422
Entity
Organization
Contact information
Practice address
367 S GULPH RD, KING OF PRUSSIA, PA 19406-3121
(610) 382-4422
Mailing address
367 S GULPH RD, KING OF PRUSSIA, PA 19406-3121
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
Primary
—
—
261QM1300X
Multi-Specialty Clinic/Center
—
—
Other
Enumeration date
10/24/2025
Last updated
10/24/2025
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