Provider Demographics
NPI:1164153565
Name:UPPERLINE HEALTHCARE PC
Entity Type:Organization
Organization Name:UPPERLINE HEALTHCARE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:VANDIVER
Authorized Official - Last Name:THORPE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-807-3009
Mailing Address - Street 1:102 WOODMONT BLVD STE 450
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37205-5202
Mailing Address - Country:US
Mailing Address - Phone:407-219-5402
Mailing Address - Fax:
Practice Address - Street 1:5066 N 900 E
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:IN
Practice Address - Zip Code:47558-5790
Practice Address - Country:US
Practice Address - Phone:812-486-3396
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-17
Last Update Date:2022-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Multi-Specialty