MEDICARE: ANKLE AND FOOT ASSOCIATES, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	213ES0103X	Foot & Ankle Surgery Podiatrist

General Provider Information

NPI Number	:	1619444965
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ANKLE AND FOOT ASSOCIATES, LLC

Provider Business Mailing Address
First Line	:	501 W ONEIDA ST
Second Line	:
City	:	WAYCROSS
State	:	GA
Zip	:	31501-5337
Country	:	US
Telephone Number	:	912-283-6471
Fax Number	:

Provider Business Practice Location Address
First Line	:	1890 S 14TH ST STE 305
Second Line	:
City	:	FERNANDINA BEACH
State	:	FL
Zip	:	32034-4794
Country	:	US
Telephone Number	:	904-326-1429
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	DAVID P MURPHY
Credential	:	DPM
Telephone Number	:	912-283-6471

Provider Enumeration Date	:	10/25/2018
Last Update Date	:	10/25/2018

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Directions to “ANKLE AND FOOT ASSOCIATES, LLC ” Practice Location

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