Organization Name: | SOUTHWEST PODIATRY, P.C. |
NPI Number: | 1689820938 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | SUSIE M AKER (OFFICE MANAGER) |
Mailing Address: | 2851 Carrollton Pike Suite A3 Woodlawn |
State: | VA US |
Postal Code: | 243813668 |
Phone Number: | 2762369663 |
Fax Number: | 2762368909 |
NPI Enumeration Date: | 08/18/2008 |
NPI Last Update Date: | 08/18/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 213ES0103X |
License Number: | 0103000769 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | VA |
Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
Taxonomy Classification: | Podiatrist |
Taxonomy Specialization: | Foot & Ankle Surgery |
Taxonomy Definition: |