Individual provider · Type 1 NPI
T Gail Stark, DPM
Primary Podiatric Medicine Podiatrist · Pensacola, FL
NPI number
1750460341
Active
Practice location
11739 Chanticleer Dr
Pensacola, FL 32507-4150
Mailing address
PO Box 34150
Pensacola, FL 32507-4150
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Podiatrist | 213E00000X | PO2420 (FL) |
| Podiatrist | 213E00000X | 160 (AL) |
| Primary Podiatric Medicine Podiatrist Primary | 213EP1101X | PO2420 (FL) |
| Primary Podiatric Medicine Podiatrist | 213EP1101X | 160 (AL) |
| Radiology Podiatrist | 213ER0200X | PO2420 (FL) |
| Radiology Podiatrist | 213ER0200X | 160 (AL) |
| Sports Medicine Podiatrist | 213ES0000X | PO2420 (FL) |
| Sports Medicine Podiatrist | 213ES0000X | 160 (AL) |
| Foot Surgery Podiatrist | 213ES0131X | PO2420 (FL) |
| Foot Surgery Podiatrist | 213ES0131X | 160 (AL) |
Primary Podiatric Medicine Podiatrist: Definition to come...
Other primary podiatric medicine podiatrist providers in Pensacola
About NPI 1750460341
T Gail Stark, DPM's National Provider Identifier is 1750460341, issued on Nov 3, 2006. The primary taxonomy on file is Primary Podiatric Medicine Podiatrist (213EP1101X), and the practice location is in Pensacola, FL. The record was last updated on May 10, 2012.