| Organization Name: | PIEDMONT PODIATRY ASSOCIATES, PLLC |
| NPI Number: | 1225093933 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | DAVID B TUCKER (OWNER) |
| Mailing Address: | 307 S Main St Reidsville |
| State: | NC US |
| Postal Code: | 273203815 |
| Phone Number: | 3363425701 |
| Fax Number: | 3363421373 |
| NPI Enumeration Date: | 04/18/2006 |
| NPI Last Update Date: | 12/06/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 213ES0103X |
| License Number: | 304 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NC |
| Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
| Taxonomy Classification: | Podiatrist |
| Taxonomy Specialization: | Foot & Ankle Surgery |
| Taxonomy Definition: | |