Organization Name: | PIEDMONT PODIATRY ASSOCIATES |
NPI Number: | 1093770521 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | DAVID TUCKER (OWNER) |
Mailing Address: | 15 Cleveland Ave Suite 9 Martinsville |
State: | VA US |
Postal Code: | 241122937 |
Phone Number: | 2766325280 |
Fax Number: | 2766325257 |
NPI Enumeration Date: | 04/18/2006 |
NPI Last Update Date: | 10/26/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 213ES0103X |
License Number: | 449 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | VA |
Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
Taxonomy Classification: | Podiatrist |
Taxonomy Specialization: | Foot & Ankle Surgery |
Taxonomy Definition: |