Provider Demographics
NPI:1568463750
Name:ENGLE, ALAN JAY (DPM)
Entity Type:Individual
Prefix:DR
First Name:ALAN
Middle Name:JAY
Last Name:ENGLE
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:3600 PRYTANIA ST
Mailing Address - Street 2:#18
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70115-3628
Mailing Address - Country:US
Mailing Address - Phone:504-891-2233
Mailing Address - Fax:504-891-2232
Practice Address - Street 1:3600 PRYTANIA ST
Practice Address - Street 2:#18
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70115-3628
Practice Address - Country:US
Practice Address - Phone:504-891-2233
Practice Address - Fax:504-891-2232
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-10
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
LAPD039R213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA56589Medicare ID - Type Unspecified
LAT19730Medicare UPIN