Provider Demographics
NPI:1023106739
Name:SOUTH CENTRAL FOOT CARE, PLLC
Entity type:Organization
Organization Name:SOUTH CENTRAL FOOT CARE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:
Authorized Official - Last Name:PORCHIA
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:870-280-2131
Mailing Address - Street 1:PO BOX 855
Mailing Address - Street 2:
Mailing Address - City:CAMDEN
Mailing Address - State:AR
Mailing Address - Zip Code:71711-0855
Mailing Address - Country:US
Mailing Address - Phone:870-280-2131
Mailing Address - Fax:870-204-7807
Practice Address - Street 1:238 CASH RD SW
Practice Address - Street 2:
Practice Address - City:CAMDEN
Practice Address - State:AR
Practice Address - Zip Code:71701-3737
Practice Address - Country:US
Practice Address - Phone:870-204-7249
Practice Address - Fax:870-675-1586
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-10
Last Update Date:2019-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARAR186213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR5U445OtherBCBS
AR5U445OtherBCBS
AR5G740Medicare PIN