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General NPI Number Information
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NPI Number | 1285863183
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Entity Type | Organization
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Legal Business Name | HAYDEN FAMILY FOOT AND ANKLE CLINIC, PLLC
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Dates
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Enumeration Date | 07/13/2009
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Last Update Date | 08/12/2013
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Provider Practice Location Address
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Address Line | 8944 N HESS ST SUITE A
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City | HAYDEN
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State | ID
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Zip | 83835-9183
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Country | US
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Telephone | 208-762-0909
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Fax | 888-762-0909
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Provider Business Mailing Address
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Address Line | 8944 N HESS ST SUITE A
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City | HAYDEN
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State | ID
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Zip | 83835-9183
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Country | US
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Telephone | 208-762-0909
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Fax | 888-762-0909
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Authorized Official
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Title or Position | OWNER
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Name | DR. JOEL DANIEL HIX
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Credential | D.P.M.
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Telephone | 509-879-9029
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP1100X
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Taxonomy Name | Podiatric Clinic/Center
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License Number | P-200
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License Number State | ID
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