Healthcare Provider Details

I. General information

NPI: 1821078072
Provider Name (Legal Business Name): CENTER FOR FOOT & ANKLE SURGERY PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/21/2006
Last Update Date: 06/12/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

684 WEST LINCOLN HIGHWAY
EXTON PA
19341
US

IV. Provider business mailing address

684 WEST LINCOLN HIGHWAY
EXTON PA
19341
US

V. Phone/Fax

Practice location:
  • Phone: 610-269-0800
  • Fax: 610-269-0510
Mailing address:
  • Phone: 610-269-0800
  • Fax: 610-269-0510

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberSC004822L
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
IdentifierCH1611607
Identifier TypeOTHER
Identifier StatePA
Identifier IssuerHIGHMARK BC BS
# 2
Identifier30021513
Identifier TypeOTHER
Identifier StatePA
Identifier IssuerKEYSTONE MERCY
# 3
Identifier2288929000
Identifier TypeOTHER
Identifier StatePA
Identifier IssuerKEYSTONE HEALTH PLAN EAST
# 4
Identifier1624760
Identifier TypeOTHER
Identifier StatePA
Identifier IssuerBLUE CHOICE
# 5
Identifier1611607
Identifier TypeOTHER
Identifier StatePA
Identifier IssuerPERSONAL CHOICE BCBS

VIII. Authorized Official

Name: DR. TIMOTHY CHEN
Title or Position: PRESIDENT
Credential: DPM
Phone: 610-269-0800