Healthcare Provider Details

I. General information

NPI: 1649862293
Provider Name (Legal Business Name): ASSOCIATED FOOT & ANKLE SPECIALISTS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/05/2021
Last Update Date: 02/05/2021
Certification Date: 02/05/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2097 HENRY TECKLENBURG DR
CHARLESTON SC
29414-5740
US

IV. Provider business mailing address

966 HARBOR OAKS DR
CHARLESTON SC
29412-4352
US

V. Phone/Fax

Practice location:
  • Phone: 843-356-9673
  • Fax:
Mailing address:
  • Phone: 843-356-9673
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DRENNAN L JOSEY
Title or Position: PRESIDENT
Credential:
Phone: 843-356-9673