Provider Demographics
NPI:1417653312
Name:BIG DOG SOLUTIONS LLC
Entity Type:Organization
Organization Name:BIG DOG SOLUTIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:SETH
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:FELICE
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:505-500-4301
Mailing Address - Street 1:51 ZUNI ST
Mailing Address - Street 2:
Mailing Address - City:LOS ALAMOS
Mailing Address - State:NM
Mailing Address - Zip Code:87544-2647
Mailing Address - Country:US
Mailing Address - Phone:218-310-7222
Mailing Address - Fax:
Practice Address - Street 1:3917 WEST RD STE 135
Practice Address - Street 2:
Practice Address - City:LOS ALAMOS
Practice Address - State:NM
Practice Address - Zip Code:87544-1776
Practice Address - Country:US
Practice Address - Phone:505-500-4301
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-01
Last Update Date:2023-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty