Healthcare Provider Details

I. General information

NPI: 1750789913
Provider Name (Legal Business Name): FEET FIRST PODIATRY, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/19/2014
Last Update Date: 12/19/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1901 COOK STREET
DYERSBURG TN
38024-1882
US

IV. Provider business mailing address

7878 WINCHESTER RD
MEMPHIS TN
38125-2307
US

V. Phone/Fax

Practice location:
  • Phone: 731-286-2139
  • Fax: 731-286-2201
Mailing address:
  • Phone: 901-365-3668
  • Fax: 901-362-7099

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DR. PAUL W HUTCHISON
Title or Position: OWNER
Credential: DPM
Phone: 807-365-3668