Healthcare Provider Details
I. General information
NPI: 1306181151
Provider Name (Legal Business Name): FORD FOOT INSTITUTE
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/05/2012
Last Update Date: 01/18/2018
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1251 MCFARLAND BLVD NE
TUSCALOOSA AL
35406-2205
US
IV. Provider business mailing address
1251 MCFARLAND BLVD NE
TUSCALOOSA AL
35406-2205
US
V. Phone/Fax
- Phone: 205-464-9619
- Fax: 205-464-9646
- Phone: 205-464-9619
- Fax: 205-464-9646
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 213E00000X |
| Taxonomy | Podiatrist |
| License Number | 307 |
| License Number State | AL |
VIII. Authorized Official
Name:
ARABI
ARASH
Title or Position: OWNER
Credential:
Phone: 205-758-8809