Healthcare Provider Details

I. General information

NPI: 1790785392
Provider Name (Legal Business Name): ANKLE AND FOOT ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/26/2005
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 S WHITE ST
BROOKVILLE PA
15825-2424
US

IV. Provider business mailing address

73 S WHITE ST
BROOKVILLE PA
15825-2427
US

V. Phone/Fax

Practice location:
  • Phone: 814-849-2073
  • Fax: 814-849-8282
Mailing address:
  • Phone: 814-849-2073
  • Fax: 814-849-8282

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number
License Number StatePA

VIII. Authorized Official

Name: MR. DEBBIE ANN MONKS
Title or Position: BUSINESS MANAGER
Credential:
Phone: 814-849-2073