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General NPI Number Information
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NPI Number | 1457432973
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Entity Type | Organization
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Legal Business Name | KINSTON PODIATRY CENTER
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Dates
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Enumeration Date | 10/18/2006
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Last Update Date | 01/04/2011
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Provider Practice Location Address
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Address Line | 402 AIRPORT ROAD
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City | KINSTON
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State | NC
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Zip | 28504-8226
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Country | US
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Telephone | 252-523-7070
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Fax | 252-523-9315
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Provider Business Mailing Address
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Address Line | 402 AIRPORT ROAD
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City | KINSTON
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State | NC
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Zip | 28504-8226
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Country | US
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Telephone | 252-523-7070
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Fax | 252-523-9315
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Authorized Official
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Title or Position | PODIATRIST
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Name | DR. DALE MICHAEL DELANEY JR.
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Credential | DPM
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Telephone | 252-523-7070
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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 | 387
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License Number State | NC
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