Provider Demographics
NPI:1669463600
Name:FOSTER, TOMMY GENE JR (LICENSED ORTHOTIST)
Entity Type:Individual
Prefix:MR
First Name:TOMMY
Middle Name:GENE
Last Name:FOSTER
Suffix:JR
Gender:M
Credentials:LICENSED ORTHOTIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2737 HIGHWAY 280 S
Mailing Address - Street 2:SUITE 141
Mailing Address - City:MOUNTAIN BROOK
Mailing Address - State:AL
Mailing Address - Zip Code:35223-2466
Mailing Address - Country:US
Mailing Address - Phone:205-870-9961
Mailing Address - Fax:205-870-9908
Practice Address - Street 1:2737 HIGHWAY 280 S
Practice Address - Street 2:SUITE 141
Practice Address - City:MOUNTAIN BROOK
Practice Address - State:AL
Practice Address - Zip Code:35223-2466
Practice Address - Country:US
Practice Address - Phone:205-870-9961
Practice Address - Fax:205-870-9908
Is Sole Proprietor?:No
Enumeration Date:2005-10-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL151174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL151OtherSTATE LICENSE NUMBER