Healthcare Provider Details

I. General information

NPI: 1942535950
Provider Name (Legal Business Name): FILLINGER FOOT CLINIC, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/08/2009
Last Update Date: 01/04/2024
Certification Date: 01/04/2024
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: DR. ERIC B FILLINGER
Title or Position: OWNER
Credential: DPM
Phone: 256-737-7339