Provider Demographics
NPI:1770791758
Name:BUNION BUSTERS
Entity type:Organization
Organization Name:BUNION BUSTERS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PODIATRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:D
Authorized Official - Last Name:OVERBY
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:251-432-3338
Mailing Address - Street 1:1401 SPRING HILL AVE
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36604-3204
Mailing Address - Country:US
Mailing Address - Phone:251-432-3338
Mailing Address - Fax:251-432-3330
Practice Address - Street 1:1401 SPRING HILL AVE
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36604-3204
Practice Address - Country:US
Practice Address - Phone:251-432-3338
Practice Address - Fax:251-432-3330
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-21
Last Update Date:2008-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL150213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot SurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALG461Medicare PIN