Provider Demographics
NPI:1346224185
Name:CAROLINA FOOT SPECIALISTS
Entity Type:Organization
Organization Name:CAROLINA FOOT SPECIALISTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DPM
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:CORY
Authorized Official - Last Name:TOBIN
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:919-846-1111
Mailing Address - Street 1:555 MEDICALE PARK WAY
Mailing Address - Street 2:STE 205
Mailing Address - City:CLAYTON
Mailing Address - State:NC
Mailing Address - Zip Code:27520
Mailing Address - Country:US
Mailing Address - Phone:919-550-0000
Mailing Address - Fax:919-570-7513
Practice Address - Street 1:555 MEDICALE PARK WAY
Practice Address - Street 2:STE 205
Practice Address - City:CLAYTON
Practice Address - State:NC
Practice Address - Zip Code:27520
Practice Address - Country:US
Practice Address - Phone:919-550-0000
Practice Address - Fax:919-570-7513
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
01394OtherBCBS
01394OtherBCBS