Provider Demographics
NPI:1699804781
Name:OEHRLEIN MEDICAL GROUP LLC
Entity type:Organization
Organization Name:OEHRLEIN MEDICAL GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PODIATRIST
Authorized Official - Prefix:
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:R
Authorized Official - Last Name:OEHRLEIN
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:205-271-7620
Mailing Address - Street 1:PO BOX 7756
Mailing Address - Street 2:
Mailing Address - City:ROCKY MOUNT
Mailing Address - State:NC
Mailing Address - Zip Code:27804-0756
Mailing Address - Country:US
Mailing Address - Phone:252-985-1371
Mailing Address - Fax:
Practice Address - Street 1:1579 OAK PARK DR
Practice Address - Street 2:
Practice Address - City:HELENA
Practice Address - State:AL
Practice Address - Zip Code:35080-7745
Practice Address - Country:US
Practice Address - Phone:205-249-2651
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-05
Last Update Date:2009-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL198213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
U71324Medicare UPIN