Provider Demographics
NPI:1891961678
Name:NORTH ALABAMA PODIATRY, LLC
Entity Type:Organization
Organization Name:NORTH ALABAMA PODIATRY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR/SOLE MBR
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:R
Authorized Official - Last Name:LINVILLE
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:256-381-3878
Mailing Address - Street 1:PO BOX 2583
Mailing Address - Street 2:
Mailing Address - City:MUSCLE SHOALS
Mailing Address - State:AL
Mailing Address - Zip Code:35662-2583
Mailing Address - Country:US
Mailing Address - Phone:256-381-3878
Mailing Address - Fax:256-381-6040
Practice Address - Street 1:2200A 2ND ST
Practice Address - Street 2:
Practice Address - City:MUSCLE SHOALS
Practice Address - State:AL
Practice Address - Zip Code:35661-1271
Practice Address - Country:US
Practice Address - Phone:256-381-3878
Practice Address - Fax:256-381-6040
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-01
Last Update Date:2015-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL0259213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL510-10708OtherBLUE CROSS BLUE SHIELD OF ALABAMA
AL6123110001Medicare NSC
ALT68885Medicare PIN