Healthcare Provider Details

I. General information

NPI: 1497400626
Provider Name (Legal Business Name): TOTAL FOOT AND ANKLE PSC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/16/2022
Last Update Date: 02/13/2023
Certification Date: 02/13/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

205 S KENTUCKY AVE
CORBIN KY
40701-1533
US

IV. Provider business mailing address

205 S KENTUCKY AVE
CORBIN KY
40701-1533
US

V. Phone/Fax

Practice location:
  • Phone: 606-280-7131
  • Fax: 606-641-0172
Mailing address:
  • Phone: 606-280-7131
  • Fax: 606-641-0172

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: DR. HEATHER E JONES
Title or Position: OWNER/AUTHORIZED OFFICIAL
Credential: DPM
Phone: 606-280-7131