Healthcare Provider Details

I. General information

NPI: 1114268554
Provider Name (Legal Business Name): TOTAL FOOT CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/11/2013
Last Update Date: 04/10/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1930 EDWARDS LAKE RD
BIRMINGHAM AL
35235-3720
US

IV. Provider business mailing address

1930 EDWARDS LAKE RD
BIRMINGHAM AL
35235-3720
US

V. Phone/Fax

Practice location:
  • Phone: 205-655-7337
  • Fax: 205-655-7338
Mailing address:
  • Phone: 205-655-7337
  • Fax: 205-655-7338

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0131X
TaxonomyFoot Surgery Podiatrist
License Number303
License Number StateAL

VIII. Authorized Official

Name: DR. COURTNEY WINSTON
Title or Position: OWNER
Credential: DPM
Phone: 205-655-7337