1265741037 NPI number — FOOT AND ANKLE HEALTHCARE CENTER

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1265741037 NPI number — FOOT AND ANKLE HEALTHCARE CENTER

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
FOOT AND ANKLE HEALTHCARE CENTER
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:
1265741037
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/23/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7051 HIGHWAY 70 S
Provider Second Line Business Mailing Address:
#170
Provider Business Mailing Address City Name:
NASHVILLE
Provider Business Mailing Address State Name:
TN
Provider Business Mailing Address Postal Code:
37221-2207
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
615-252-6929
Provider Business Mailing Address Fax Number:
615-252-6929

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1994 GALLATIN RD N
Provider Second Line Business Practice Location Address:
#310
Provider Business Practice Location Address City Name:
MADISON
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37115
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
615-252-6929
Provider Business Practice Location Address Fax Number:
615-252-6929
Provider Enumeration Date:
09/28/2010

Additional Information

Authorized Official

Authorized Official Last Name:
APRIL
Authorized Official First Name:
CARMEN
Authorized Official Middle Name:
B
Authorized Official Title or Position:
DOCTOR OF PODIATRIC MEDICINE
Authorized Official Telephone Number:
615-252-6929

Provider Taxonomy Codes

  • Taxonomy code: 213ES0103X , with the licence number:  702 , registered in the state of TN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 1520179 , issued by the state of ( TN ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com