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General NPI Number Information
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NPI Number | 1932371242
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Entity Type | Organization
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Legal Business Name | THOMAS F ERTLE DPM
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Dates
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Enumeration Date | 03/26/2008
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Last Update Date | 04/16/2008
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Provider Practice Location Address
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Address Line | 161 E WATER ST
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City | BELHAVEN
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State | NC
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Zip | 27810-1448
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Country | US
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Telephone | 252-944-2272
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Fax | 252-944-2270
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Provider Business Mailing Address
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Address Line | 161 E WATER ST
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City | BELHAVEN
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State | NC
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Zip | 27810-1448
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Country | US
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Telephone | 252-944-2272
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Fax | 252-944-2270
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Authorized Official
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Title or Position | OWNER
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Name | DR. THOMAS F ERTLE
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Credential | DPM
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Telephone | 252-944-2272
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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 | NC243
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License Number State | NC
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