Provider Demographics
NPI:1063680775
Name:PERSONAL FOOT CARE, P.C.
Entity Type:Organization
Organization Name:PERSONAL FOOT CARE, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/ OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:ZAGAR
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:334-358-9765
Mailing Address - Street 1:546 MCQUEEN SMITH RD N
Mailing Address - Street 2:
Mailing Address - City:PRATTVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:36066-5558
Mailing Address - Country:US
Mailing Address - Phone:334-358-9765
Mailing Address - Fax:334-358-5434
Practice Address - Street 1:546 MCQUEEN SMITH RD N
Practice Address - Street 2:
Practice Address - City:PRATTVILLE
Practice Address - State:AL
Practice Address - Zip Code:36066-5558
Practice Address - Country:US
Practice Address - Phone:334-358-9765
Practice Address - Fax:334-358-5434
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-15
Last Update Date:2008-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL229213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL1303190001Medicare NSC