Organization Name: | BAY PODIATRY, L.L.C. |
NPI Number: | 1013128875 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | ROBERT E JOHNSON (MANAGER) |
Mailing Address: | 400 Saraland Blvd N Saraland |
State: | AL US |
Postal Code: | 365712152 |
Phone Number: | 2514420863 |
Fax Number: | |
NPI Enumeration Date: | 05/24/2007 |
NPI Last Update Date: | 02/08/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QP1100X |
License Number: | 238 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AL |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Podiatric |
Taxonomy Definition: |