1902836885 NPI number — CAHABA PODIATRY, INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1902836885 NPI number — CAHABA PODIATRY, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CAHABA PODIATRY, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1902836885
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/20/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 273
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CHELSEA
Provider Business Mailing Address State Name:
AL
Provider Business Mailing Address Postal Code:
35043-0273
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
205-980-2005
Provider Business Mailing Address Fax Number:
205-980-6889

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5511 HIGHWAY 280
Provider Second Line Business Practice Location Address:
SUITE 124
Provider Business Practice Location Address City Name:
BIRMINGHAM
Provider Business Practice Location Address State Name:
AL
Provider Business Practice Location Address Postal Code:
35242-6585
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
205-980-2005
Provider Business Practice Location Address Fax Number:
205-980-6889
Provider Enumeration Date:
07/04/2006

Additional Information

Authorized Official

Authorized Official Last Name:
YEAGER-SMITH
Authorized Official First Name:
LORA
Authorized Official Middle Name:
D.
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
205-980-2005

Provider Taxonomy Codes

  • Taxonomy code: 213ES0131X , with the licence number:  161 , registered in the state of AL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 51046369 . This is a "BCBS PROVIDER NUMBER" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com