Provider Demographics
NPI:1487986097
Name:DOROTHY WALBEY DPM PA
Entity type:Organization
Organization Name:DOROTHY WALBEY DPM PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DOROTHY
Authorized Official - Middle Name:
Authorized Official - Last Name:WALBEY
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:904-982-8841
Mailing Address - Street 1:11144 APPLE BLOSSOM TRL W
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32218-7363
Mailing Address - Country:US
Mailing Address - Phone:904-982-8841
Mailing Address - Fax:904-766-7414
Practice Address - Street 1:2255 DUNN AVE
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32218-4719
Practice Address - Country:US
Practice Address - Phone:904-982-8841
Practice Address - Fax:904-766-7414
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-06
Last Update Date:2011-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO3102213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty