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General NPI Number Information
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NPI Number | 1710005491
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Entity Type | Organization
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Legal Business Name | CAPITOL FOOT & ANKLE, LLC
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Dates
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Enumeration Date | 03/27/2007
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Last Update Date | 12/21/2007
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Provider Practice Location Address
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Address Line | 5256 DAWES AVE
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City | ALEXANDRIA
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State | VA
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Zip | 22311-1404
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Country | US
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Telephone | 703-578-3899
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Fax | 703-578-8950
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Provider Business Mailing Address
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Address Line | 5256 DAWES AVE.
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City | ALEXANDRIA
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State | VA
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Zip | 22311
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Country | US
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Telephone | 703-578-3899
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Fax | 703-578-8950
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. MELISSA ORDAN SMITH
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Credential | D.P.M.
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Telephone | 703-578-3899
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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 | 0103300905
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License Number State | VA
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