Healthcare Provider Details

I. General information

NPI: 1619083581
Provider Name (Legal Business Name): PREMIER ANKLE & FOOT SPECIALISTS PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/22/2006
Last Update Date: 04/24/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2410 S QUEEN ST
YORK PA
17402-4941
US

IV. Provider business mailing address

2410 S QUEEN ST
YORK PA
17402-4941
US

V. Phone/Fax

Practice location:
  • Phone: 717-718-5511
  • Fax: 717-718-5381
Mailing address:
  • Phone: 717-718-5511
  • Fax: 717-718-5381

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberSC005598
License Number StatePA

VIII. Authorized Official

Name: DR. JEFFREY E KAUFFMAN
Title or Position: PRESIDENT
Credential: DPM
Phone: 717-718-5511