Excelsior Podiatry Clinic Pllc

NPI 1003085515 - Podiatrist - 213ES0103X

NPI Details
NPI 1003085515
Enumeration Date 02/28/2008
Last Updated 04/13/2010
Entity Type Healthcare Provider
Active Over 8 years ago
Authorized Information
Name JOHN JOHN
Position DOCTOR
Phone (901) 516-4005
Fax (901) 516-4023
Practice Location
214 LAKEVIEW RD
SOMERVILLE TN, 38068-9737, US
Phone (901) 516-4005
Fax (901) 516-4023
Business Location
PO BOX 460
OAKLAND TN, 38060-0460, US
Phone (901) 516-4005
Fax (901) 516-4023
Toxanomy
Taxonomy Code 213ES0103X
License State Tennessee
License Number DPM0000000649
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According to our database, Excelsior Podiatry Clinic Pllc NPI is 1003085515, taxonomy code is 213ES0103X and license number is DPM0000000649, license state is located at Tennessee. Excelsior Podiatry Clinic Pllc physically located at 214 Lakeview Rd, Somerville TN, 38068-9737. NPI Number 1033115704 has the healthcare provider type.

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1003085515 NPI number is provided on an as is basis without warranty of any kind. 1003085515 is maintained by the National Plan & Provider Enumeration System. The contents of Excelsior Podiatry Clinic Pllc are for informational purposes only.