Organization
ADVANCED FOOT CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CARY TRENT DONOHUE DPM (OWNER)
(504) 439-8530
Entity
Organization
Contact information
Practice address
831 DUBLIN ST, NEW ORLEANS, LA 70118-1023
(504) 439-8530
(504) 861-3132
Mailing address
831 DUBLIN ST, NEW ORLEANS, LA 70118-1023
(504) 439-8530
(504) 861-3132
Taxonomy
Speciality
Code
Description
License number
State
213EP1101X
Primary Podiatric Medicine Podiatrist
Primary
PD195R
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
05001054
—
MS
05
—
1549525
—
LA
01
—
523
PODIATRY MEDICAL LICENSE - VOLUTARILLY PLACED ON INNACTIVE STATUS
SC
01
—
80180
PODIATRY MEDICAL LICENSE
MS
01
—
PD195R
PODIATRY MEDICAL LICENSE
LA
05
—
PD5232
—
SC
Enumeration date
09/26/2013
Last updated
10/10/2013
Update your record
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