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General NPI Number Information
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NPI Number | 1346214947
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Entity Type | Organization
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Legal Business Name | FOOT AND ANKLE SURGICAL CENTER LLC
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Dates
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Enumeration Date | 02/13/2006
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Last Update Date | 11/15/2007
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Provider Practice Location Address
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Address Line | 1224 S QUEEN ST
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City | YORK
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State | PA
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Zip | 17403-3923
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Country | US
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Telephone | 717-848-4401
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Fax | 717-718-4043
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Provider Business Mailing Address
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Address Line | 1224 S QUEEN ST
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City | YORK
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State | PA
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Zip | 17403-3923
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Country | US
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Telephone | 717-848-4401
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Fax | 717-718-4043
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Authorized Official
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Title or Position | MANAGING PARTNER
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Name | MR. R. CRAIG MARTIN
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Credential | D.P.M.
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Telephone | 717-848-4401
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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 | 17791501
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License Number State | PA
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