Healthcare Provider Details

I. General information

NPI: 1821645987
Provider Name (Legal Business Name): GATEWAY FOOT AND ANKLE CENTER, PLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/23/2019
Last Update Date: 08/23/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4230 HARDING PIKE SUITE G12
NASHVILLE TN
37205
US

IV. Provider business mailing address

647 DUNLOP LANE SUTIE 209
CLARKSVILLE TN
37040
US

V. Phone/Fax

Practice location:
  • Phone: 615-301-7054
  • Fax:
Mailing address:
  • Phone: 615-851-0144
  • Fax: 615-851-0144

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number
License Number State

VIII. Authorized Official

Name: DAVID E SMITH
Title or Position: OWNER
Credential: DPM
Phone: 931-245-1920