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General NPI Number Information
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NPI Number | 1699171868
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Entity Type | Organization
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Legal Business Name | PREMIER FOOT & ANKLE PLLC
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Dates
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Enumeration Date | 11/14/2014
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Last Update Date | 05/23/2024
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Provider Practice Location Address
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Address Line | 821 S HORNER BLVD
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City | SANFORD
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State | NC
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Zip | 27330-4224
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Country | US
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Telephone | 919-292-1610
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Fax |
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Provider Business Mailing Address
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Address Line | 821 S HORNER BLVD
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City | SANFORD
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State | NC
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Zip | 27330-5359
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. RONALD TALIS
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Credential | DPM
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Telephone | 216-702-4388
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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 | 609
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License Number State | NC
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