Provider Demographics
NPI:1003003922
Name:GERALD B CALIA
Entity Type:Organization
Organization Name:GERALD B CALIA
Other - Org Name:ADVANCED FAMILY FOOTCARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KATHERINE
Authorized Official - Middle Name:P
Authorized Official - Last Name:SHARP
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-563-2010
Mailing Address - Street 1:162 RIDGEWAY CTR
Mailing Address - Street 2:
Mailing Address - City:OAK RIDGE
Mailing Address - State:TN
Mailing Address - Zip Code:37830-6926
Mailing Address - Country:US
Mailing Address - Phone:865-482-3441
Mailing Address - Fax:865-483-6299
Practice Address - Street 1:162 RIDGEWAY CTR
Practice Address - Street 2:
Practice Address - City:OAK RIDGE
Practice Address - State:TN
Practice Address - Zip Code:37830-6926
Practice Address - Country:US
Practice Address - Phone:865-482-3441
Practice Address - Fax:865-483-6299
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-25
Last Update Date:2015-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN213EP1101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3351215Medicare PIN
TN1232770001Medicare NSC