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WIREGRASS PODIATRY LLC NPI 1952873283


NPI Information

NPI: 1952873283
Provider Name: WIREGRASS PODIATRY LLC
Classification: Podiatrist - 213E00000X
Entity Type: Organization

CLIA Number: 01D2082958

Address:
1008 BOLL WEEVIL CIR STE B
ENTERPRISE, AL
ZIP 36330
Phone: (334) 494-8200
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WIREGRASS PODIATRY LLC is a podiatrist in Enterprise, AL. The provider is a podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical and other operative procedures, prescribe corrective devices and prescribe and administer drugs and physical therapy. WIREGRASS PODIATRY LLC NPI is 1952873283. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1008 BOLL WEEVIL CIR STE B
ENTERPRISE, AL
ZIP 36330-400
Phone: (334) 494-8200
Fax: (334) 460-1984

The provider's authorized official is Jennifer Rose Decker .
The authorized official title is Administrator and has the following contact phone number (334) 494-8200.

The CLIA number assigned to this NPI record is 01D2082958 - other - pregnancy help ctr with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 12/27/2018 and was last updated on 9/28/2020.


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:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1213E00000XPodiatristYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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