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General NPI Number Information
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NPI Number | 1093042632
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Entity Type | Organization
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Legal Business Name | SANTA FE FOOT AND ANKLE INSTITUTE, LLC
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Dates
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Enumeration Date | 11/03/2009
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Last Update Date | 06/14/2015
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Provider Practice Location Address
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Address Line | 2019 GALISTEO ST UNIT A4
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City | SANTA FE
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State | NM
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Zip | 87505-2143
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Country | US
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Telephone | 505-988-3338
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Fax | 505-982-3668
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Provider Business Mailing Address
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Address Line | 2019 GALISTEO ST UNIT A4
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City | SANTA FE
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State | NM
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Zip | 87505-2143
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Country | US
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Telephone | 505-988-3338
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Fax | 505-982-3668
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Authorized Official
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Title or Position | MEMBER/OWNER
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Name | GLENDA L KING
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Credential | DPM
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Telephone | 505-988-3338
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number |
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License Number State |
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Taxonomy #2
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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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