Healthcare Provider Details

I. General information

NPI: 1649911637
Provider Name (Legal Business Name): TOE-TAL FOOT CARE, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/05/2022
Last Update Date: 01/25/2023
Certification Date: 01/25/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101A DORIS CT
HOT SPRINGS AR
71913-4044
US

IV. Provider business mailing address

101A DORIS CT
HOT SPRINGS AR
71913-4044
US

V. Phone/Fax

Practice location:
  • Phone: 501-500-0155
  • Fax: 501-246-8647
Mailing address:
  • Phone: 501-500-0155
  • Fax: 501-246-8647

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number
License Number State

VIII. Authorized Official

Name: DR. TIMOTHY WAYNE GAULDIN
Title or Position: OWNER
Credential: DPM
Phone: 501-500-0155