Healthcare Provider Details

I. General information

NPI: 1588673420
Provider Name (Legal Business Name): MICHAEL H GOLF D.P.M.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/07/2006
Last Update Date: 05/25/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4310 JAMES CASEY ST SUITE 3A
AUSTIN TX
78745-1251
US

IV. Provider business mailing address

4310 JAMES CASEY ST STE 3A
AUSTIN TX
78745-1120
US

V. Phone/Fax

Practice location:
  • Phone: 512-448-3668
  • Fax: 512-448-4460
Mailing address:
  • Phone: 512-448-3668
  • Fax: 512-448-4460

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0131X
TaxonomyFoot Surgery Podiatrist
License Number0582
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: