Healthcare Provider Details
I. General information
NPI: 1437589389
Provider Name (Legal Business Name): NEUHAUS FOOT AND ANKLE, PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/13/2013
Last Update Date: 11/13/2013
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1424 W BADDOUR PKWY STE E
LEBANON TN
37087-2685
US
IV. Provider business mailing address
300 STONECREST BLVD STE 350
SMYRNA TN
37167-6860
US
V. Phone/Fax
- Phone: 615-449-1737
- Fax: 615-220-8688
- Phone: 615-220-8788
- Fax: 615-220-8688
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 213E00000X |
| Taxonomy | Podiatrist |
| License Number | DPM609 |
| License Number State | TN |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 213EP1101X |
| Taxonomy | Primary Podiatric Medicine Podiatrist |
| License Number | DPM609 |
| License Number State | TN |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 213ES0103X |
| Taxonomy | Foot & Ankle Surgery Podiatrist |
| License Number | DPM609 |
| License Number State | TN |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 213ES0131X |
| Taxonomy | Foot Surgery Podiatrist |
| License Number | DPM609 |
| License Number State | TN |
VIII. Authorized Official
Name: DR.
MATTHEW
D.
NEUHAUS
Title or Position: PRESIDENT/PODIATRIST
Credential: DPM
Phone: 615-220-8788