=====================================================
General NPI Number Information
=====================================================
NPI Number | 1568463750
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ALAN JAY ENGLE D.P.M.
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/10/2005
-----------------------------------------------------
Last Update Date | 07/09/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3600 PRYTANIA ST #18
-----------------------------------------------------
City | NEW ORLEANS
-----------------------------------------------------
State | LA
-----------------------------------------------------
Zip | 70115-3628
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 504-891-2233
-----------------------------------------------------
Fax | 504-891-2232
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3600 PRYTANIA ST #18
-----------------------------------------------------
City | NEW ORLEANS
-----------------------------------------------------
State | LA
-----------------------------------------------------
Zip | 70115-3628
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 504-891-2233
-----------------------------------------------------
Fax | 504-891-2232
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 213E00000X
-----------------------------------------------------
Taxonomy Name | Podiatrist
-----------------------------------------------------
License Number | PD039R
-----------------------------------------------------
License Number State | LA
-----------------------------------------------------