Blasingame, Tara L. F.

Blasingame, Tara L. F. is an individual health care provider with primary practice located at 131 W Dublin Dr Suite A, Madison AL 35758-1787. She recently has only one registered license in Podiatric Medicine & Surgery Service Providers / Foot Surgery, which is considered as her primary health care specialty. Blasingame, Tara L. F. can be contacted via phone (256) 772-8566.

Contact Information

Primary practice address
131 W Dublin Dr Suite A Madison AL 35758-1787
Phone: (256) 772-8566
Fax: (256) 774-8211
Website:
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Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Foot Surgery 213ES0131X AL164 Alabama
Podiatric Medicine & Surgery Service Providers / Foot Surgery 213ES0131X 714 Georgia

Profile Details

NPI number 1770565699
LBN Legal business name Blasingame, Tara L. F.
Credentials Doctor of Podiatric Medicine (DPM)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 16th, 2005
Last updated Mar 28th, 2012 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1770565699 NPPES
Alabama Other 510452548 TRICARE
Alabama Other 051514659 TRICARE
Alabama MEDICAID 890010830 TRICARE
Alabama MEDICAID 890010840 TRICARE
Alabama Other 051514658 TRICARE

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