| Organization Name: | WAKE FOOT AND ANKLE CENTER PLLC |
| NPI Number: | 1033376959 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | LEAH M JUDGE (PRACTICE MANAGER) |
| Mailing Address: | 833 Wake Forest Business Park Ste C Wake Forest |
| State: | NC US |
| Postal Code: | 275876519 |
| Phone Number: | 9195709061 |
| Fax Number: | 9195709064 |
| NPI Enumeration Date: | 05/19/2008 |
| NPI Last Update Date: | 02/23/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 213ES0103X |
| License Number: | 389 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NC |
| Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
| Taxonomy Classification: | Podiatrist |
| Taxonomy Specialization: | Foot & Ankle Surgery |
| Taxonomy Definition: | |