Healthcare Provider Details

I. General information

NPI: 1508263781
Provider Name (Legal Business Name): DR TOMS FOOT AND ANKLE CLINIC PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/03/2014
Last Update Date: 09/01/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3911 BATTLEGROUND AVE
GREENSBORO NC
27410-9499
US

IV. Provider business mailing address

3911 BATTLEGROUND AVE
GREENSBORO NC
27410-9499
US

V. Phone/Fax

Practice location:
  • Phone: 336-763-9355
  • Fax: 336-763-9354
Mailing address:
  • Phone: 336-763-9355
  • Fax: 336-763-9354

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code213EP1101X
TaxonomyPrimary Podiatric Medicine Podiatrist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number
License Number State

VIII. Authorized Official

Name: WILLIAM TOMASZEWSKI
Title or Position: PRESIDENT
Credential: DPM
Phone: 336-763-9355