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General NPI Number Information
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NPI Number | 1083395792
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Entity Type | Organization
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Legal Business Name | TAPPAHANNOCK FOOT AND ANKLE SPECIALIST INC
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Dates
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Enumeration Date | 07/26/2023
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Last Update Date | 12/13/2023
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Provider Practice Location Address
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Address Line | 402 AIRPORT ROAD
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City | TAPPAHANNOCK
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State | VA
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Zip | 22560-5431
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Country | US
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Telephone | 804-925-6027
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Fax | 804-925-6064
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Provider Business Mailing Address
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Address Line | 402 AIRPORT ROAD
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City | TAPPAHANNOCK
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State | VA
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Zip | 22560-5431
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Country | US
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Telephone | 804-925-6027
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Fax | 804-925-6024
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Authorized Official
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Title or Position | OWNER/PROVIDER
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Name | JOON S. HWANG
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Credential | DPM
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Telephone | 804-925-6027
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number |
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License Number State |
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