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General NPI Number Information
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NPI Number | 1669755542
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Entity Type | Organization
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Legal Business Name | ALEX CITY FOOT SPECIALTIES, LLC
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Dates
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Enumeration Date | 09/27/2011
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Last Update Date | 09/27/2011
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Provider Practice Location Address
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Address Line | 1649 HIGHWAY 22 W STE 1
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City | ALEXANDER CITY
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State | AL
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Zip | 35010-4415
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Country | US
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Telephone | 256-215-5596
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Fax | 256-215-5551
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Provider Business Mailing Address
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Address Line | 1649 HIGHWAY 22 W STE 1
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City | ALEXANDER CITY
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State | AL
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Zip | 35010-4415
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Country | US
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Telephone | 256-215-5596
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Fax | 256-215-5551
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Authorized Official
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Title or Position | OWNER
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Name | DOUGLAS D STEWART
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Credential | DPM
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Telephone | 256-215-5596
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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 | 163
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License Number State | AL
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