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General NPI Number Information
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NPI Number | 1710043856
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Entity Type | Organization
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Legal Business Name | GADSDEN FOOT CLINIC, P.C.
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Dates
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Enumeration Date | 12/30/2006
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Last Update Date | 09/18/2013
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Provider Practice Location Address
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Address Line | 306 S 4TH ST
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City | GADSDEN
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State | AL
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Zip | 35901-5213
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Country | US
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Telephone | 256-547-1631
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Fax | 256-547-1632
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Provider Business Mailing Address
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Address Line | 306 S 4TH ST
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City | GADSDEN
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State | AL
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Zip | 35901-5213
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Country | US
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Telephone | 256-547-1631
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Fax |
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | DONNA CHATHAM WAGGONER
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Credential |
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Telephone | 256-547-1631
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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 |
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License Number State |
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