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General NPI Number Information
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NPI Number | 1306045588
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Entity Type | Organization
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Legal Business Name | LAKEVIEW FAMILY FOOT CARE L.L.C.
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Dates
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Enumeration Date | 07/17/2007
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Last Update Date | 06/02/2010
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Provider Practice Location Address
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Address Line | 1604 BLOUNT AVE
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City | GUNTERSVILLE
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State | AL
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Zip | 35976-1840
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Country | US
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Telephone | 256-582-7486
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Fax | 256-582-9844
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Provider Business Mailing Address
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Address Line | P.O. BOX 404
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City | GUNTERSVILLE
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State | AL
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Zip | 35976-1840
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Country | US
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Telephone | 256-582-7486
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Fax | 256-582-9844
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Authorized Official
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Title or Position | PODIATRIST/OWNER
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Name | DR. GERARD ALFRED SKAZIAK
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Credential | DPM
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Telephone | 256-582-7486
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0131X
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Taxonomy Name | Foot Surgery Podiatrist
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License Number | 171
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License Number State | AL
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