Provider Demographics
NPI:1043756513
Name:BESSEMER FAMILY FOOT CLINIC LLC
Entity Type:Organization
Organization Name:BESSEMER FAMILY FOOT CLINIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PODIATRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:
Authorized Official - Last Name:HOBDY
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:205-424-2540
Mailing Address - Street 1:1721 4TH AVE N
Mailing Address - Street 2:
Mailing Address - City:BESSEMER
Mailing Address - State:AL
Mailing Address - Zip Code:35020-4838
Mailing Address - Country:US
Mailing Address - Phone:205-424-2540
Mailing Address - Fax:
Practice Address - Street 1:1721 4TH AVE N
Practice Address - Street 2:
Practice Address - City:BESSEMER
Practice Address - State:AL
Practice Address - Zip Code:35020-4838
Practice Address - Country:US
Practice Address - Phone:205-424-2540
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-09
Last Update Date:2017-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL00174213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL009912146MCDMedicaid
ALU66520Medicare UPIN