| Organization Name: | MID-SOUTH FOOT & ANKLE CLINIC P C |
| NPI Number: | 1154571495 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | BHEKUMUZI M KHUMALO (CEO) |
| Mailing Address: | 302 S Rhodes St West Memphis |
| State: | AR US |
| Postal Code: | 723014215 |
| Phone Number: | 8707323131 |
| Fax Number: | 8707321301 |
| NPI Enumeration Date: | 09/23/2008 |
| NPI Last Update Date: | 09/29/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 213ES0103X |
| License Number: | 177 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AR |
| Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
| Taxonomy Classification: | Podiatrist |
| Taxonomy Specialization: | Foot & Ankle Surgery |
| Taxonomy Definition: | |