Provider Demographics
NPI:1558530279
Name:CARL R ALBRIGHT DPM
Entity Type:Organization
Organization Name:CARL R ALBRIGHT DPM
Other - Org Name:ALBRIGHT PODIATRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CARL
Authorized Official - Middle Name:R
Authorized Official - Last Name:ALBRIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:570-326-1400
Mailing Address - Street 1:1140 SHERIDAN ST
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSPORT
Mailing Address - State:PA
Mailing Address - Zip Code:17701-3618
Mailing Address - Country:US
Mailing Address - Phone:570-326-1400
Mailing Address - Fax:570-326-2505
Practice Address - Street 1:1140 SHERIDAN ST
Practice Address - Street 2:
Practice Address - City:WILLIAMSPORT
Practice Address - State:PA
Practice Address - Zip Code:17701-3618
Practice Address - Country:US
Practice Address - Phone:570-326-1400
Practice Address - Fax:570-326-2505
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-27
Last Update Date:2008-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASC001372L213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA6048950001Medicare NSC