Organization Name: | MENDOZA FOOT & ANKLE CENTER PC |
NPI Number: | 1053502252 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | DANIEL MENDOZA (PRESIDENT) |
Mailing Address: | 336 Sumner Hall Dr Gallatin |
State: | TN US |
Postal Code: | 370663129 |
Phone Number: | 6154528899 |
Fax Number: | |
NPI Enumeration Date: | 08/05/2007 |
NPI Last Update Date: | 01/25/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 213ES0103X |
License Number: | DPM442 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TN |
Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
Taxonomy Classification: | Podiatrist |
Taxonomy Specialization: | Foot & Ankle Surgery |
Taxonomy Definition: |