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NPI Code Detail

MEDICARE: BLUE RIDGE FOOTCARE AND SURGERY PLC

MEDICARE: BLUE RIDGE FOOTCARE AND SURGERY PLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1213E00000XPodiatrist0103300877VA

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2DG6187OTHERVAMEDICARE RR GROUIP

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11588847982OTHERVANPI GROUP
31336330620OTHERVANPI GROUP
4MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1336330620
Entity Type Code : Organization
Provider Name (Legal Business Name) : BLUE RIDGE FOOTCARE AND SURGERY PLC
Provider Business Mailing Address
First Line : 111 FAIRWAY LN STE 100
Second Line :
City : STAUNTON
State : VA
Zip : 24401-3576
Country : US
Telephone Number : 540-885-8891
Fax Number : 540-885-0016
Provider Business Practice Location Address
First Line : 111 FAIRWAY LN STE 100
Second Line :
City : STAUNTON
State : VA
Zip : 24401-3576
Country : US
Telephone Number : 540-885-8891
Fax Number : 540-885-0016
Authorized Official
Title or Position : OWNER
Name : THEODORE MCKEE
Credential : DPM
Telephone Number : 540-885-8891
Provider Enumeration Date : 08/05/2007
Last Update Date : 12/10/2025

Similar Medicare Providers

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Directions to “BLUE RIDGE FOOTCARE AND SURGERY PLC ” Practice Location

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