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General NPI Number Information
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NPI Number | 1841203957
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Entity Type | Individual
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Provider Name | BRETT S STARK DPM
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Gender | Male
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Dates
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Enumeration Date | 08/14/2006
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Last Update Date | 10/26/2020
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Provider Practice Location Address
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Address Line | 890 N DEAN RD STE 400
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City | AUBURN
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State | AL
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Zip | 36830-9440
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Country | US
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Telephone | 334-466-1401
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Fax | 334-641-0075
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Provider Business Mailing Address
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Address Line | 300 N DEAN RD SUITE 5 PMB 180
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City | AUBURN
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State | AL
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Zip | 36830-4404
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Country | US
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Telephone | 334-466-1401
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Fax | 334-466-1433
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213EP1101X
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Taxonomy Name | Primary Podiatric Medicine Podiatrist
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License Number | 225
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License Number State | AL
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