| Organization Name: | PRIME FOOT CARE, PLLC |
| NPI Number: | 1073557799 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | CARLA ARNETTE MARTIN (PODTIATRIST) |
| Mailing Address: | 9065 Sandidge Center Cove Ste C Olive Branch |
| State: | MS US |
| Postal Code: | 386543574 |
| Phone Number: | 6628930533 |
| Fax Number: | 6628905676 |
| NPI Enumeration Date: | 06/15/2006 |
| NPI Last Update Date: | 11/12/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP1100X |
| License Number: | 80159 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MS |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Podiatric |
| Taxonomy Definition: | |