| Organization Name: | BRUNSWICK FOOT & ANKLE SURGERY |
| NPI Number: | 1396874285 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JOSEPH KIBLER (OWNER) |
| Mailing Address: | 14 Doctors Cir Suite 2 Supply |
| State: | NC US |
| Postal Code: | 284624097 |
| Phone Number: | 9197519120 |
| Fax Number: | 9197519170 |
| NPI Enumeration Date: | 03/05/2007 |
| NPI Last Update Date: | 09/21/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 213ES0103X |
| License Number: | 452 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | NC |
| Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
| Taxonomy Classification: | Podiatrist |
| Taxonomy Specialization: | Foot & Ankle Surgery |
| Taxonomy Definition: | |