Provider Demographics
NPI:1164465878
Name:FOOT AND ANKLE CENTER OF MOBILE BAY, P.C.
Entity type:Organization
Organization Name:FOOT AND ANKLE CENTER OF MOBILE BAY, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CATHERINE
Authorized Official - Middle Name:DENISE
Authorized Official - Last Name:AGEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:251-343-5971
Mailing Address - Street 1:705 BISHOP LN N
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36608-5838
Mailing Address - Country:US
Mailing Address - Phone:251-343-5971
Mailing Address - Fax:251-343-7589
Practice Address - Street 1:705 BISHOP LN N
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36608-5838
Practice Address - Country:US
Practice Address - Phone:251-373-5971
Practice Address - Fax:251-373-7589
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-13
Last Update Date:2025-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL00041332B00000X
261QP1100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QP1100XAmbulatory Health Care FacilitiesClinic/CenterPodiatricGroup - Single Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL480028125OtherRAILROAD PTAN
AL480000819OtherRAILROAD PTAN
ALH589OtherMEDICARE GROUP
AL480028125OtherRAILROAD PTAN
ALH589OtherMEDICARE GROUP
ALT68883Medicare UPIN
ALU74928Medicare UPIN
AL000040946Medicare PIN
AL0495240001Medicare NSC