Provider Demographics
NPI:1457469793
Name:BAY FOOT LLC
Entity Type:Organization
Organization Name:BAY FOOT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER PODIATRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:KATHRYN
Authorized Official - Middle Name:MORGAN
Authorized Official - Last Name:LIGHTCAP
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:302-644-0100
Mailing Address - Street 1:334 SAVANNAH RD
Mailing Address - Street 2:
Mailing Address - City:LEWES
Mailing Address - State:DE
Mailing Address - Zip Code:19958-1449
Mailing Address - Country:US
Mailing Address - Phone:302-644-0100
Mailing Address - Fax:302-644-0238
Practice Address - Street 1:334 SAVANNAH RD
Practice Address - Street 2:
Practice Address - City:LEWES
Practice Address - State:DE
Practice Address - Zip Code:19958-1449
Practice Address - Country:US
Practice Address - Phone:302-644-0100
Practice Address - Fax:302-644-0238
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-28
Last Update Date:2016-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE0000629450Medicaid
D46083Medicare UPIN
DE0000629450Medicaid
DE476761Medicare PIN