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NPI Code Detail

MEDICARE: PIEDMONT PODIATRY ASSOCIATES

MEDICARE: PIEDMONT PODIATRY ASSOCIATES
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1213ES0103XFoot & Ankle Surgery Podiatrist449VA

General Provider Information

NPI Number : 1093770521
Entity Type Code : Organization
Provider Name (Legal Business Name) : PIEDMONT PODIATRY ASSOCIATES
Provider Business Mailing Address
First Line : 15 CLEVELAND AVE
Second Line : SUITE 9
City : MARTINSVILLE
State : VA
Zip : 24112-2937
Country : US
Telephone Number : 276-632-5280
Fax Number : 276-632-5257
Provider Business Practice Location Address
First Line : 15 CLEVELAND AVE
Second Line : SUITE 9
City : MARTINSVILLE
State : VA
Zip : 24112-2937
Country : US
Telephone Number : 276-632-5280
Fax Number : 276-632-5257
Authorized Official
Title or Position : OWNER
Name : DR. DAVID TUCKER
Credential :
Telephone Number : 276-632-5280
Provider Enumeration Date : 04/18/2006
Last Update Date : 10/26/2007

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Directions to “PIEDMONT PODIATRY ASSOCIATES ” Practice Location

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