Healthcare Provider Details

I. General information

NPI: 1699804781
Provider Name (Legal Business Name): OEHRLEIN MEDICAL GROUP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/05/2007
Last Update Date: 02/16/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1579 OAK PARK DR
HELENA AL
35080-7745
US

IV. Provider business mailing address

PO BOX 7756
ROCKY MOUNT NC
27804-0756
US

V. Phone/Fax

Practice location:
  • Phone: 205-249-2651
  • Fax:
Mailing address:
  • Phone: 252-985-1371
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number198
License Number StateAL

VIII. Authorized Official

Name: CHARLES R OEHRLEIN
Title or Position: PODIATRIST
Credential: DPM
Phone: 205-271-7620