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NPI Code Detail

MEDICARE: BAY PODIATRY CENTER, PA

MEDICARE: BAY PODIATRY CENTER, PA
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
1213E00000XPodiatrist

General Provider Information

NPI Number : 1699711176
Entity Type Code : Organization
Provider Name (Legal Business Name) : BAY PODIATRY CENTER, PA
Provider Business Mailing Address
First Line : 2430 JENKS AVE
Second Line :
City : PANAMA CITY
State : FL
Zip : 32405-4304
Country : US
Telephone Number : 850-763-7244
Fax Number : 850-763-0157
Provider Business Practice Location Address
First Line : 2430 JENKS AVE
Second Line :
City : PANAMA CITY
State : FL
Zip : 32405-4304
Country : US
Telephone Number : 850-763-7244
Fax Number : 850-763-0157
Authorized Official
Title or Position : OWNER
Name : DR. FRED E GAITHER
Credential : DPM
Telephone Number : 850-763-7244
Provider Enumeration Date : 06/21/2006
Last Update Date : 08/22/2020

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Directions to “BAY PODIATRY CENTER, PA ” Practice Location

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