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General NPI Number Information
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NPI Number | 1598926073
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Entity Type | Organization
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Legal Business Name | QUALITY FOOT CARE LLC
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Dates
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Enumeration Date | 06/18/2008
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Last Update Date | 09/29/2022
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Provider Practice Location Address
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Address Line | 2743 MARIAH LN
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City | SOUTHAVEN
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State | MS
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Zip | 38672-7166
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Country | US
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Telephone | 662-420-9637
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Fax |
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Provider Business Mailing Address
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Address Line | 2743 MARIAH LANE
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City | SOUTHAVEN
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State | MS
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Zip | 38672-6037
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Country | US
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Telephone | 662-420-9637
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Fax |
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Authorized Official
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Title or Position | PODIATRIST
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Name | DR. JOHN S CATAFYGIOTU
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Credential | DPM
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Telephone | 662-420-9637
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | 80184
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License Number State | MS
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