Basic Information
| Provider Information | |||||||||
| NPI: | 1043804669 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | UPPERLINE HEALTHCARE, PC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 102 WOODMONT BLVD STE 450 | ||||||||
| Address2: | |||||||||
| City: | NASHVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 372055202 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6156272193 | ||||||||
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| Practice Location | |||||||||
| Address1: | 819 E OAK ST STE B | ||||||||
| Address2: | |||||||||
| City: | KISSIMMEE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 347445842 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4078461234 | ||||||||
| FaxNumber: | 4078469253 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/24/2021 | ||||||||
| LastUpdateDate: | 02/24/2021 | ||||||||
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| AuthorizedOfficialLastName: | THORPE | ||||||||
| AuthorizedOfficialFirstName: | DAVID | ||||||||
| AuthorizedOfficialMiddleName: | VANDIVER | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 2058073009 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 02/05/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 213ES0103X | Y | 193200000X MULTI-SPECIALTY GROUP | Podiatric Medicine & Surgery Service Providers | Podiatrist | Foot & Ankle Surgery |
No ID Information.