Organization
BRENDA L CASSELBERRY
Active
Parent organization
BRENDA L CASSELBERRY
Other names
Auburn Opelika Ambulatory-Surg Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
BRENDA L CASSELBERRY
Authorized official
DR. BRENDA L CASSELBERRY DPM (PHYSICIAN / PRESIDENT)
(334) 705-0544
Entity
Organization
Contact information
Practice address
2121 EXECUTIVE PARK DR, OPELIKA, AL 36801-6041
(334) 705-0544
(334) 705-0531
Mailing address
PO BOX 1268, AUBURN, AL 36831-1268
(334) 705-0544
(334) 705-0548
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
132
AL
332B00000X
Durable Medical Equipment & Medical Supplies
132
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1750484358
NPI - INDIVIDUAL
AL
01
—
480013769
MEDICARE R/R
AL
01
—
5043300001
PALMETTO - GBA DMERC OPER
AL
01
—
51540360
BCBS - TUSKEGEE
AL
01
—
51540725
BCBS - OPELIKA
AL
05
—
529912550
—
AL
Enumeration date
01/30/2008
Last updated
01/07/2009
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