Healthcare Provider Details

I. General information

NPI: 1861322661
Provider Name (Legal Business Name): ALABAMA FOOT CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/22/2026
Last Update Date: 05/22/2026
Certification Date: 05/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2165 HIGHWAY 78 STE 103
DORA AL
35062-4539
US

IV. Provider business mailing address

PO BOX 97
SIPSEY AL
35584-0097
US

V. Phone/Fax

Practice location:
  • Phone: 205-617-1026
  • Fax:
Mailing address:
  • Phone: 205-617-1026
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: JASON SCOTT PATTERSON
Title or Position: OWNER/OPERATOR
Credential: CRNP, CFCS
Phone: 205-617-1026