| Organization Name: | PROFESSIONAL FOOT AND ANKLE CENTERS, PC |
| NPI Number: | 1104025220 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MARK R WILLIAMS (PROVIDER) |
| Mailing Address: | 605 S State Rd Davison |
| State: | MI US |
| Postal Code: | 484231515 |
| Phone Number: | 8106539060 |
| Fax Number: | 8106582248 |
| NPI Enumeration Date: | 07/18/2007 |
| NPI Last Update Date: | 06/28/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 213ES0103X |
| License Number: | MW001983 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MI |
| Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
| Taxonomy Classification: | Podiatrist |
| Taxonomy Specialization: | Foot & Ankle Surgery |
| Taxonomy Definition: | |