Doctor Name: | JOHN FJERSTAD |
NPI Number: | 1477528313 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | D.P.M. |
License Number: | DP00335 |
Business Practice Address: | 1967 Central Ave Mckinleyville, CA - 955193605 |
Business Phone Number: | 7078400226 |
Business Fax Number: | 7078400422 |
Mailing Address: | 1967 Central Ave, MCKINLEYVILLE |
State: | CA |
Postal Code: | 955193605 |
Phone Number: | 7078400226 |
Fax Number: | 7078400422 |
NPI Enumeration Date: | 02/22/2006 |
NPI Last Update Date: | 02/18/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 213ES0103X |
License Number: | DP00335 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | OR |
Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
Taxonomy Classification: | Podiatrist |
Taxonomy Specialization: | Foot & Ankle Surgery |
Taxonomy Definition: |