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General NPI Number Information
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NPI Number | 1942371919
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Entity Type | Organization
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Legal Business Name | EBERHARDT FOOT & ANKLE CLINIC
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Dates
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Enumeration Date | 11/13/2006
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Last Update Date | 06/02/2015
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Provider Practice Location Address
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Address Line | 111 DENNIS DR STE 123
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City | SANFORD
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State | NC
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Zip | 27330-6461
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Country | US
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Telephone | 919-776-0300
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Fax | 919-776-0511
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Provider Business Mailing Address
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Address Line | 111 DENNIS DR STE 123
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City | SANFORD
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State | NC
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Zip | 27330-6461
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Country | US
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Telephone | 919-776-0300
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Fax | 919-776-0511
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Authorized Official
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Title or Position | PRESIDENT & CEO
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Name | DR. KEVIN NEAL EBERHARDT
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Credential | D.P.M.
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Telephone | 919-776-0300
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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 | 332
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number |
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License Number State |
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