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NPI Code Detail

MEDICARE: ULTIMATE FOOT CARE LLC

MEDICARE: ULTIMATE FOOT CARE LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QP1100XPodiatric Clinic/CenterLA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1669619797
Entity Type Code : Organization
Provider Name (Legal Business Name) : ULTIMATE FOOT CARE LLC
Provider Business Mailing Address
First Line : 3224 SAINT CLAUDE AVE
Second Line :
City : NEW ORLEANS
State : LA
Zip : 70117-6659
Country : US
Telephone Number : 504-945-8102
Fax Number :
Provider Business Practice Location Address
First Line : 3224 ST CLAUDE AVENUE
Second Line :
City : NEW ORLEANS
State : LA
Zip : 70117
Country : US
Telephone Number : 504-945-8102
Fax Number :
Authorized Official
Title or Position : CEO/ OWNER
Name : DR. MICHELLE E. G. DONALDSON-BAILEY
Credential : DPM
Telephone Number : 504-945-8102
Provider Enumeration Date : 01/12/2009
Last Update Date : 02/25/2011

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Directions to “ULTIMATE FOOT CARE LLC ” Practice Location

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