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General NPI Number Information
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NPI Number | 1538307863
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Entity Type | Organization
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Legal Business Name | FOOT CARE AND SURGICAL CENTER
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Dates
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Enumeration Date | 01/23/2009
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Last Update Date | 01/23/2009
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Provider Practice Location Address
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Address Line | 120 5TH AVE
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City | MCCOMB
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State | MS
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Zip | 39648-4159
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Country | US
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Telephone | 601-362-3158
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Fax | 601-987-8800
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Provider Business Mailing Address
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Address Line | 47026 SCOTT DR
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City | HAMMOND
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State | LA
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Zip | 70401-7323
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | GERARD G GUERIN
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Credential |
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Telephone | 985-320-0584
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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