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DR. JOHN SAMUEL BIDELSPACH DPM
Foot & Ankle Surgery >> Podiatrist >> Podiatric Medicine & Surgery Service ProvidersRegistrant NPI Number: 1326299512
Individual Registrant:DR. JOHN SAMUEL BIDELSPACH DPM
Gender: M
Sole Proprietor
Gender: M
Sole Proprietor
Location and contact information for practice:
487 BAYOU VILLAGE DR TARPON SPRINGS, FL 34689-3607 US
Tel: 866-362-3668 Fax: 866-596-7195
Tel: 866-362-3668 Fax: 866-596-7195
Contact information for business:
PO BOX 2497 TARPON SPRINGS, FL 34688-2497 US
Tel: 866-362-3668 Fax: 866-596-7195
Tel: 866-362-3668 Fax: 866-596-7195
Registration Information:
NPI: 1326299512
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 213ES0103X | Podiatric Medicine & Surgery Service Providers Podiatrist Foot & Ankle Surgery | FL | P0002345 |
| N | 213ES0103X | Podiatric Medicine & Surgery Service Providers Podiatrist | GA | 657 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
