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General NPI Number Information
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NPI Number | 1982929170
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Entity Type | Organization
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Legal Business Name | HIGHLANDS PODIATRY, P.L.C.
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Dates
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Enumeration Date | 03/31/2010
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Last Update Date | 04/16/2013
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Provider Practice Location Address
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Address Line | 391 FALLS DR NW
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City | ABINGDON
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State | VA
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Zip | 24210-8093
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Country | US
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Telephone | 423-764-2299
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Fax | 423-968-3340
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Provider Business Mailing Address
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Address Line | 2765 W STATE ST
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City | BRISTOL
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State | TN
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Zip | 37620-1828
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Country | US
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Telephone | 423-764-2299
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Fax | 423-968-3340
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Authorized Official
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Title or Position | CHIEF MANAGER/PODIATRIST
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Name | JOHN CHRISTOPHER ALLEN
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Credential | D.P.M.
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Telephone | 423-764-2299
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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 | 0103301011
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License Number State | VA
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