Provider Demographics
NPI:1225038748
Name:WEBSTER, JULIE CATHLEEN (DPM)
Entity Type:Individual
Prefix:DR
First Name:JULIE
Middle Name:CATHLEEN
Last Name:WEBSTER
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:DR
Other - First Name:JULIE
Other - Middle Name:KATE
Other - Last Name:WEBSTER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DPM
Mailing Address - Street 1:8055 CLUB PKWY
Mailing Address - Street 2:
Mailing Address - City:CORDOVA
Mailing Address - State:TN
Mailing Address - Zip Code:38016-5967
Mailing Address - Country:US
Mailing Address - Phone:901-309-7700
Mailing Address - Fax:901-507-3297
Practice Address - Street 1:8055 CLUB PKWY
Practice Address - Street 2:
Practice Address - City:CORDOVA
Practice Address - State:TN
Practice Address - Zip Code:38016-5967
Practice Address - Country:US
Practice Address - Phone:901-309-7700
Practice Address - Fax:901-507-3297
Is Sole Proprietor?:No
Enumeration Date:2005-07-27
Last Update Date:2020-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN602213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3353819Medicaid
TN3353819Medicaid
TN3353837Medicare ID - Type Unspecified