Southern Podiatry Foot And Ankle, PLLC
in Madison, AL. Organization (NPI-2).
NPI number1497984397
StatusActive
Last updated in NPPESDec 12, 2024
Details
- NPI
- 1497984397
- Entity type
- Organization (NPI-2)
- Legal business name
- Southern Podiatry Foot And Ankle, PLLC
- Organization subpart
- No
- Enumeration date
- Jul 13, 2009
- Certification date
- Dec 12, 2024
- Last updated
- Dec 12, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 213ES0131X | 299 | AL | Yes |
Practice location
8000 Madison Blvd Ste D102-341Madison, AL 35758-2031
Phone 312-752-7713
Mailing address
1311 Grandeview Blvd Apt 1928Huntsville, AL 35824-2408
Phone 312-752-7713
Authorized official
Elyse N Tiller
Cpcs
6159567919
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