Organization
THE FOOT GROUP P C
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TARA L. F. BLASINGAME D. P. M. (PRESIDENT)
(256) 772-8566
Entity
Organization
Contact information
Practice address
131 W DUBLIN DR, SUITE A, MADISON, AL 35758-1787
(256) 772-8566
(256) 774-8211
Mailing address
PO BOX 6487, HUNTSVILLE, AL 35813-0487
(256) 772-8566
(256) 774-8211
Taxonomy
Speciality
Code
Description
License number
State
213ES0131X
Foot Surgery Podiatrist
Primary
AL164
AL
261QP1100X
Podiatric Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
051514658
THE FOOT GROUP'S GROUP #
AL
01
—
051514659
THE FOOT GROUP'S BCBS #
AL
05
—
529918240
—
AL
05
—
529918270
—
AL
01
—
Q112
BCBS GROUP PAYEE NUMBER
AL
Enumeration date
11/13/2005
Last updated
04/19/2020
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