Provider Demographics
NPI:1750389649
Name:STREMMEL, TIMOTHY WAYNE (DPM)
Entity type:Individual
Prefix:DR
First Name:TIMOTHY
Middle Name:WAYNE
Last Name:STREMMEL
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 1:708 E 10TH ST
Mailing Address - Street 2:
Mailing Address - City:ANNISTON
Mailing Address - State:AL
Mailing Address - Zip Code:36207-4756
Mailing Address - Country:US
Mailing Address - Phone:256-238-9991
Mailing Address - Fax:256-238-9931
Practice Address - Street 1:708 E 10TH ST
Practice Address - Street 2:
Practice Address - City:ANNISTON
Practice Address - State:AL
Practice Address - Zip Code:36207-4756
Practice Address - Country:US
Practice Address - Phone:256-238-9991
Practice Address - Fax:256-238-9931
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-13
Last Update Date:2019-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL178213ES0131X, 213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
No213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL1238110001OtherMEDICARE DME
AL51077215OtherBCBS OF AL PROVIDER #
AL721398333OtherTAX ID NUMBER
AL51077215OtherBCBS OF AL PROVIDER #
AL000077215Medicare ID - Type Unspecified