Provider Demographics
NPI:1841458684
Name:TUSCANY PODIATRY, PC
Entity type:Organization
Organization Name:TUSCANY PODIATRY, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR, BUSINESS OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:MARY
Authorized Official - Last Name:ANTERO
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:205-758-8809
Mailing Address - Street 1:215 HARGROVE RD E
Mailing Address - Street 2:
Mailing Address - City:TUSCALOOSA
Mailing Address - State:AL
Mailing Address - Zip Code:35401-5027
Mailing Address - Country:US
Mailing Address - Phone:205-758-8809
Mailing Address - Fax:205-758-8870
Practice Address - Street 1:215 HARGROVE RD E
Practice Address - Street 2:
Practice Address - City:TUSCALOOSA
Practice Address - State:AL
Practice Address - Zip Code:35401-5027
Practice Address - Country:US
Practice Address - Phone:205-758-8809
Practice Address - Fax:205-758-8870
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-29
Last Update Date:2018-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL136213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL000074235Medicare PIN
ALU27894Medicare UPIN
AL1041420001Medicare NSC