Provider Demographics
NPI:1437686425
Name:MARSHALL COUNTY FOOT CLINIC, LLC
Entity Type:Organization
Organization Name:MARSHALL COUNTY FOOT CLINIC, LLC
Other - Org Name:MARSHALL FOOT CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PODIATRIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBSON
Authorized Official - Middle Name:F
Authorized Official - Last Name:ARAUJO
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:256-840-4810
Mailing Address - Street 1:601A CORLEY AVE
Mailing Address - Street 2:
Mailing Address - City:BOAZ
Mailing Address - State:AL
Mailing Address - Zip Code:35957-5957
Mailing Address - Country:US
Mailing Address - Phone:256-840-4810
Mailing Address - Fax:256-840-4815
Practice Address - Street 1:7633 AL HIGHWAY 69
Practice Address - Street 2:
Practice Address - City:GUNTERSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35976-7137
Practice Address - Country:US
Practice Address - Phone:256-571-8750
Practice Address - Fax:256-571-8767
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-22
Last Update Date:2017-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot SurgeryGroup - Single Specialty
No213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty