Organization
AUBURN OPELIKA FAMILY FOOTCARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRENDA L CASSELBERRY DPM (PRESIDENT / PHYSICIAN)
(334) 705-0544
Entity
Organization
Contact information
Practice address
2121 EXECUTIVE PARK DR, OPELIKA, AL 36801-6041
(334) 705-0544
(334) 705-0548
Mailing address
PO BOX 1268, AUBURN, AL 36831-1268
(334) 705-0544
(334) 705-0548
Taxonomy
Speciality
Code
Description
License number
State
261QP1100X
Podiatric Clinic/Center
Primary
132
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1750484358
INDIVIDUAL NPI
AL
01
—
480013769
MEDICARE R/R PIN
AL
01
—
51540360
BCBSAL- TUSKEGEE
AL
01
—
51540725
BCBSAL--OPELIKA
AL
05
—
529912550
—
AL
01
—
CM3112
MEDICARE R/R GROUP PIN
AL
Enumeration date
08/30/2007
Last updated
07/14/2008
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