Provider Demographics
NPI:1114308335
Name:ROSEMARIE CAILLIER, DPM, PC
Entity Type:Organization
Organization Name:ROSEMARIE CAILLIER, DPM, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROSEMARIE
Authorized Official - Middle Name:JACK
Authorized Official - Last Name:CAILLIER
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:585-203-7486
Mailing Address - Street 1:3546 BROOK HIGHLAND DR
Mailing Address - Street 2:
Mailing Address - City:TUSCALOOSA
Mailing Address - State:AL
Mailing Address - Zip Code:35406-2952
Mailing Address - Country:US
Mailing Address - Phone:205-409-0175
Mailing Address - Fax:205-764-5937
Practice Address - Street 1:2002 MCFARLAND BLVD E
Practice Address - Street 2:SUITE 207
Practice Address - City:TUSCALOOSA
Practice Address - State:AL
Practice Address - Zip Code:35404-5856
Practice Address - Country:US
Practice Address - Phone:205-409-0175
Practice Address - Fax:205-764-5800
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-12
Last Update Date:2016-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL313213EP1101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL187474Medicaid
AL7528390001Medicare NSC