Provider Demographics
NPI:1093855348
Name:BAY PODIATRY, L.L.C.
Entity Type:Organization
Organization Name:BAY PODIATRY, L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:P
Authorized Official - Last Name:MURPHY
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:251-621-8699
Mailing Address - Street 1:30723A EMBER LN
Mailing Address - Street 2:SUITE 2
Mailing Address - City:SPANISH FORT
Mailing Address - State:AL
Mailing Address - Zip Code:36527-5105
Mailing Address - Country:US
Mailing Address - Phone:251-621-8699
Mailing Address - Fax:251-621-7450
Practice Address - Street 1:30723A EMBER LN
Practice Address - Street 2:SUITE 2
Practice Address - City:SPANISH FORT
Practice Address - State:AL
Practice Address - Zip Code:36527-5105
Practice Address - Country:US
Practice Address - Phone:251-621-8699
Practice Address - Fax:251-621-7450
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-07
Last Update Date:2008-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL238213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL51098551OtherBCBS
AL51514149OtherBCBS
AL51098551OtherBCBS
ALL088Medicare PIN
ALU80997Medicare UPIN
AL51514149OtherBCBS
AL4150380001Medicare NSC