Healthcare Provider Details
I. General information
NPI: 1588303630
Provider Name (Legal Business Name): UPPERLINE HEALTHCARE, PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/27/2022
Last Update Date: 05/27/2022
Certification Date: 05/27/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
705 BISHOP LN N
MOBILE AL
36608-5838
US
IV. Provider business mailing address
102 WOODMONT BLVD STE 450
NASHVILLE TN
37205-5202
US
V. Phone/Fax
- Phone: 251-343-5971
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 213ES0103X |
| Taxonomy | Foot & Ankle Surgery Podiatrist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
DAVID
VANDIVER
THORPE
Title or Position: CEO
Credential:
Phone: 205-807-3009