Provider Demographics
NPI:1205387263
Name:GIAIMO MOBILE PODIATRY PLLC
Entity Type:Organization
Organization Name:GIAIMO MOBILE PODIATRY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:
Authorized Official - Last Name:GIAIMO
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:502-244-2441
Mailing Address - Street 1:12910 SHELBYVILLE RD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40243-1593
Mailing Address - Country:US
Mailing Address - Phone:502-244-2441
Mailing Address - Fax:502-254-4069
Practice Address - Street 1:106 PADGETT DR
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:KY
Practice Address - Zip Code:42031-1313
Practice Address - Country:US
Practice Address - Phone:855-259-9183
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-14
Last Update Date:2016-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY00375213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty