Healthcare Provider Details

I. General information

NPI: 1710157953
Provider Name (Legal Business Name): FOOTCARE SOLUTIONS, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/04/2008
Last Update Date: 05/14/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 E APPLETREE ST
SCOTTSBORO AL
35768-1835
US

IV. Provider business mailing address

PO BOX 11191
HUNTSVILLE AL
35814-1191
US

V. Phone/Fax

Practice location:
  • Phone: 256-755-0680
  • Fax: 888-381-8569
Mailing address:
  • Phone: 256-755-0680
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0131X
TaxonomyFoot Surgery Podiatrist
License Number197
License Number StateAL

VIII. Authorized Official

Name: DR. DESIREE J MCGANN
Title or Position: OWNER
Credential: DPM
Phone: 256-755-0680