Individual
BRETT S STARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
890 N DEAN RD STE 400, AUBURN, AL 36830-9440
(334) 466-1401
(334) 641-0075
Mailing address
300 N DEAN RD, SUITE 5 PMB 180, AUBURN, AL 36830-4404
(334) 466-1401
(334) 466-1433
Taxonomy
Speciality
Code
Description
License number
State
213EP1101X
Primary Podiatric Medicine Podiatrist
Primary
225
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
051503568
BLUE CROSS BLUE SHIELD
AL
01
—
051529739
BLUE CROSS BLUE SHIELD
—
01
—
051530652
BLUE CROSS BLUE SHIELD
—
01
—
480033606
RR MCR
—
Enumeration date
08/14/2006
Last updated
10/26/2020
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