1053493221 NPI number — EARNEST FOOT AND ANKLE SPECIALISTS PLC

Table of content: (NPI 1053493221)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1053493221 NPI number — EARNEST FOOT AND ANKLE SPECIALISTS PLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
EARNEST FOOT AND ANKLE SPECIALISTS PLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1053493221
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/20/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1336 ALVERSER PLZ
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MIDLOTHIAN
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
23113-2604
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
804-594-1944
Provider Business Mailing Address Fax Number:
804-594-1945

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1336 ALVERSER PLZ
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MIDLOTHIAN
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
23113-2604
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
804-594-1944
Provider Business Practice Location Address Fax Number:
804-594-1945
Provider Enumeration Date:
10/19/2006

Additional Information

Authorized Official

Authorized Official Last Name:
EARNEST
Authorized Official First Name:
RUSSELL
Authorized Official Middle Name:
D.
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
804-594-1944

Provider Taxonomy Codes

  • Taxonomy code: 213E00000X , with the licence number:  0103300896 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 389911 . This is a "ANTHEM - RUSS" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 232349 . This is a "SOUTHERN HEALTH" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: FIRST HEALTH . This is a "FIRST HEALTH" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 427297361 . This is a "TRICARE" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 010049351 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 7797532 . This is a "AETNA" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 7330335 . This is a "CIGNA" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 010136296 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 160546960 . This is a "TRICARE" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 2126938 . This is a "MAMSI" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 3106155 . This is a "CIGNA" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".




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