Excelsior Podiatry Clinic PLLC

Organization Active NPI Exclusive Provider Organization · Somerville, TN

NPI 1124350087 · NPPES record last updated Feb 3, 2010

Key facts

NPI
1124350087
Entity type
Organization (NPI type 2)
Primary specialty
Exclusive Provider Organization 302F00000X
License
DPM0000000649 (TN)
Legal business name
EXCELSIOR PODIATRY CLINIC PLLC
Practice address
214 Lakeview Rd
Somerville, TN 38068-9737
Phone
(901) 516-4005
Fax
(901) 516-4023
NPI assigned
Feb 3, 2010
Organization subpart
No

Authorized official

Name
Dr. John Elijah Bell, DPM
Title
Ceo, President
Phone
(901) 516-4005

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Exclusive Provider Organization 302F00000X DPM0000000649 TN Yes

Addresses

Primary practice location

214 Lakeview Rd
Somerville, TN 38068-9737

Mailing address

PO Box 460
Oakland, TN 38060-0460
Phone (901) 516-4005

Other providers in Somerville, TN

All providers in Somerville, TN · Exclusive Provider Organization in Tennessee

Sources for this page

Verify at the official NPI Registry.