Organization Name: | NC PODIATRIC PHYSICIANS AND SURGEONS GROUP, PLLC |
NPI Number: | 1427302686 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JOSEPH F KIBLER (PARTNER) |
Mailing Address: | 509 Olde Waterford Way Suite 305 Leland |
State: | NC US |
Postal Code: | 284514125 |
Phone Number: | 9107556512 |
Fax Number: | 9107556548 |
NPI Enumeration Date: | 11/08/2012 |
NPI Last Update Date: | 11/08/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 213ES0103X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
Taxonomy Classification: | Podiatrist |
Taxonomy Specialization: | Foot & Ankle Surgery |
Taxonomy Definition: |