Provider Demographics
NPI:1609146273
Name:DYE, GEOFFREY HARRISON (DPM)
Entity Type:Individual
Prefix:DR
First Name:GEOFFREY
Middle Name:HARRISON
Last Name:DYE
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7067 VETERANS PKWY STE 200
Mailing Address - Street 2:
Mailing Address - City:PELL CITY
Mailing Address - State:AL
Mailing Address - Zip Code:35125-5128
Mailing Address - Country:US
Mailing Address - Phone:205-777-9574
Mailing Address - Fax:205-814-2334
Practice Address - Street 1:7063 VETERANS PKWY STE 200
Practice Address - Street 2:
Practice Address - City:PELL CITY
Practice Address - State:AL
Practice Address - Zip Code:35125-5114
Practice Address - Country:US
Practice Address - Phone:205-777-9574
Practice Address - Fax:205-814-2334
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-12
Last Update Date:2022-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN718213ES0103X
AL00314213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
No213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL00314OtherALABAMA STATE BOARD OF PODIATRY
TN718OtherTN STATE ACADEMIC LICENSE