EASTERN SHORE FOOT CENTER P.C. NPI 1417004656

NPI Information

EASTERN SHORE FOOT CENTER, P.C. is a foot surgery podiatrist in Daphne, AL. EASTERN SHORE FOOT CENTER, P.C. NPI is 1417004656. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1913 US HIGHWAY 98
DAPHNE, AL
ZIP 36526-371
Phone: (251) 626-5065
Fax: (251) 626-7580

The provider's authorized official is Randell Braun .
The authorized official title is President and has the following contact phone number (251) 626-5065.

The enumeration date for this NPI number is 1/3/2007 and was last updated on 11/18/2010.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

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