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General NPI Number Information
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NPI Number | 1457423881
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Entity Type | Organization
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Legal Business Name | FIRST STEP FOOT AND ANKLE CENTER LLC
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Dates
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Enumeration Date | 11/14/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1006 BIRCHFIELD DRIVE
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City | MOUNT LAUREL
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State | NJ
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Zip | 08054
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Country | US
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Telephone | 856-996-0100
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Fax | 856-996-0102
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Provider Business Mailing Address
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Address Line | 1006 BIRCHFIELD DRIVE
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City | MOUNT LAUREL
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State | NJ
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Zip | 08054
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Country | US
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Telephone | 856-996-0100
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Fax | 856-996-0102
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Authorized Official
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Title or Position | PODIATRIST
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Name | DR. SCOTT E JONES
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Credential | DPM
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Telephone | 856-996-0100
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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 | 25MD00121000
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | 25MD00260100
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License Number State | NJ
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