Healthcare Provider Details

I. General information

NPI: 1386738276
Provider Name (Legal Business Name): HUNTSVILLE PODIATRY CENTER PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/03/2006
Last Update Date: 03/10/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

929 FRANKLIN ST SE
HUNTSVILLE AL
35801-4301
US

IV. Provider business mailing address

929 FRANKLIN ST SE
HUNTSVILLE AL
35801-4301
US

V. Phone/Fax

Practice location:
  • Phone: 256-533-3624
  • Fax:
Mailing address:
  • Phone: 256-533-3624
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0131X
TaxonomyFoot Surgery Podiatrist
License Number30
License Number StateAL

VIII. Authorized Official

Name: DR. EDWARD A BEHMER
Title or Position: OWNER
Credential: DPM
Phone: 256-533-3624