Individual
RICK THORNTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
1060 GRANDVIEW BLVD, SUITE 623, HUNTSVILLE, AL 35824-1497
(312) 752-7713
Mailing address
1060 GRANDVIEW BLVD, SUITE 623, HUNTSVILLE, AL 35824-1497
(312) 752-7713
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
016005314
IL
213E00000X
Podiatrist
Primary
299
AL
213E00000X
Podiatrist
689
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01636612
BCBS PROVIDER #
IL
01
—
06-1763397
TAX ID #
IL
05
—
112600
—
AL
01
—
510-49599
BCBSAL
AL
Enumeration date
06/18/2007
Last updated
01/09/2023
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