Provider Demographics
NPI:1538326053
Name:ALABAMA NURSING HOME FOOT CARE
Entity Type:Organization
Organization Name:ALABAMA NURSING HOME FOOT CARE
Other - Org Name:NEW FOOT CENTER OF ALABAMA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:BARRY
Authorized Official - Middle Name:J
Authorized Official - Last Name:GOULD
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:205-759-9100
Mailing Address - Street 1:1788 MCFARLAND BLVD N
Mailing Address - Street 2:SUITE B
Mailing Address - City:TUSCALOOSA
Mailing Address - State:AL
Mailing Address - Zip Code:35406-2190
Mailing Address - Country:US
Mailing Address - Phone:205-759-9100
Mailing Address - Fax:205-759-1821
Practice Address - Street 1:1788 MCFARLAND BLVD N
Practice Address - Street 2:SUITE B
Practice Address - City:TUSCALOOSA
Practice Address - State:AL
Practice Address - Zip Code:35406-2190
Practice Address - Country:US
Practice Address - Phone:205-759-9100
Practice Address - Fax:205-759-1821
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-21
Last Update Date:2010-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL272213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL6253450001Medicare NSC