Healthcare Provider Details

I. General information

NPI: 1992865794
Provider Name (Legal Business Name): TOMMY W GARNETT DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/11/2006
Last Update Date: 07/13/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

74186 TALLASSEE HIGHWAY STE A
WETUMPKA AL
36092-5644
US

IV. Provider business mailing address

PO BOX 242848
MONTGOMERY AL
36124-2848
US

V. Phone/Fax

Practice location:
  • Phone: 334-514-6922
  • Fax: 334-514-6068
Mailing address:
  • Phone: 334-270-9914
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213EP0504X
TaxonomyPublic Medicine Podiatrist
License Number162
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: