Healthcare Provider Details

I. General information

NPI: 1316229511
Provider Name (Legal Business Name): SALISBURY FOOT & ANKLE CENTER, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/13/2011
Last Update Date: 09/23/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

217 MOCKSVILLE AVE
SALISBURY NC
28144-3325
US

IV. Provider business mailing address

217 MOCKSVILLE AVE
SALISBURY NC
28144-3325
US

V. Phone/Fax

Practice location:
  • Phone: 704-636-7575
  • Fax:
Mailing address:
  • Phone: 704-636-7575
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number309
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number309
License Number StateNC

VIII. Authorized Official

Name: DR. JAMES D CUSACK
Title or Position: PRESIDENT
Credential: DPM
Phone: 704-636-7575