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General NPI Number Information
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NPI Number | 1477701217
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Entity Type | Organization
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Legal Business Name | DISTRICT PODIATRY, PLLC
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Dates
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Enumeration Date | 09/05/2008
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Last Update Date | 09/05/2008
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Provider Practice Location Address
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Address Line | 1647 BENNING RD NE SUITE 200
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City | WASHINGTON
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State | DC
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Zip | 20002-4569
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Country | US
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Telephone | 202-388-5303
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Fax | 202-388-5305
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Provider Business Mailing Address
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Address Line | 1647 BENNING RD NE SUITE 200
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City | WASHINGTON
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State | DC
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Zip | 20002-4569
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Country | US
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Telephone | 202-388-5303
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Fax | 202-388-5305
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Authorized Official
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Title or Position | OWNER
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Name | DR. LUBRINA E LOUIS-JACQUES
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Credential | DPM
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Telephone | 202-388-5303
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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 | 0103300768
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License Number State | VA
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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 | P01000007
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License Number State | DC
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