Healthcare Provider Details

I. General information

NPI: 1235102708
Provider Name (Legal Business Name): ERIC B FILLINGER DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/07/2006
Last Update Date: 12/02/2021
Certification Date: 12/02/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 WALL ST
CULLMAN AL
35055-6011
US

IV. Provider business mailing address

1400 WALL ST
CULLMAN AL
35055-6011
US

V. Phone/Fax

Practice location:
  • Phone: 256-739-7339
  • Fax: 256-737-7340
Mailing address:
  • Phone: 256-739-7339
  • Fax: 256-737-7340

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0131X
TaxonomyFoot Surgery Podiatrist
License Number191
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: