Provider Demographics
NPI:1891734034
Name:KAYE, MICHAEL R (DPM)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:R
Last Name:KAYE
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 1:6316 PICCADILLY SQUARE DR # A
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36609-5143
Mailing Address - Country:US
Mailing Address - Phone:205-822-8038
Mailing Address - Fax:205-822-8040
Practice Address - Street 1:6316 PICCADILLY SQUARE DR # A
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36609-5143
Practice Address - Country:US
Practice Address - Phone:205-822-8038
Practice Address - Fax:205-822-8040
Is Sole Proprietor?:No
Enumeration Date:2006-06-05
Last Update Date:2018-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAPD146R213E00000X
AL329213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1936201Medicaid
LA1936201Medicaid
LA397540YH87Medicare PIN