Provider Demographics
NPI:1710157953
Name:FOOTCARE SOLUTIONS, PC
Entity Type:Organization
Organization Name:FOOTCARE SOLUTIONS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DESIREE
Authorized Official - Middle Name:J
Authorized Official - Last Name:MCGANN
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:256-755-0680
Mailing Address - Street 1:PO BOX 11191
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35814-1191
Mailing Address - Country:US
Mailing Address - Phone:256-755-0680
Mailing Address - Fax:
Practice Address - Street 1:101 E APPLETREE ST
Practice Address - Street 2:
Practice Address - City:SCOTTSBORO
Practice Address - State:AL
Practice Address - Zip Code:35768-1835
Practice Address - Country:US
Practice Address - Phone:256-755-0680
Practice Address - Fax:888-381-8569
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-04
Last Update Date:2008-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL197213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL510G700165Medicare PIN