Provider Demographics
NPI:1750789913
Name:FEET FIRST PODIATRY, PC
Entity type:Organization
Organization Name:FEET FIRST PODIATRY, PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:W
Authorized Official - Last Name:HUTCHISON
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:807-365-3668
Mailing Address - Street 1:7878 WINCHESTER RD
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38125-2307
Mailing Address - Country:US
Mailing Address - Phone:901-365-3668
Mailing Address - Fax:901-362-7099
Practice Address - Street 1:1901 COOK STREET
Practice Address - Street 2:
Practice Address - City:DYERSBURG
Practice Address - State:TN
Practice Address - Zip Code:38024-1882
Practice Address - Country:US
Practice Address - Phone:731-286-2139
Practice Address - Fax:731-286-2201
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-19
Last Update Date:2014-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1531380Medicaid
TN1531380Medicaid
TN1891743241Medicare PIN