Provider Demographics
NPI:1811627458
Name:UPPERLINE HEALTHCARE PC
Entity Type:Organization
Organization Name:UPPERLINE HEALTHCARE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:KING
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:401-787-0999
Mailing Address - Street 1:102 WOODMONT BLVD STE 450
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37205-5202
Mailing Address - Country:US
Mailing Address - Phone:407-219-5405
Mailing Address - Fax:
Practice Address - Street 1:3305 N EVERBROOK LN
Practice Address - Street 2:
Practice Address - City:MUNCIE
Practice Address - State:IN
Practice Address - Zip Code:47304-5271
Practice Address - Country:US
Practice Address - Phone:765-284-4220
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-15
Last Update Date:2023-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Multi-Specialty