Provider Demographics
NPI:1053493221
Name:EARNEST FOOT AND ANKLE SPECIALISTS PLC
Entity Type:Organization
Organization Name:EARNEST FOOT AND ANKLE SPECIALISTS PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RUSSELL
Authorized Official - Middle Name:D
Authorized Official - Last Name:EARNEST
Authorized Official - Suffix:JR
Authorized Official - Credentials:DPM
Authorized Official - Phone:804-594-1944
Mailing Address - Street 1:1336 ALVERSER PLZ
Mailing Address - Street 2:
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:VA
Mailing Address - Zip Code:23113-2604
Mailing Address - Country:US
Mailing Address - Phone:804-594-1944
Mailing Address - Fax:804-594-1945
Practice Address - Street 1:1336 ALVERSER PLZ
Practice Address - Street 2:
Practice Address - City:MIDLOTHIAN
Practice Address - State:VA
Practice Address - Zip Code:23113-2604
Practice Address - Country:US
Practice Address - Phone:804-594-1944
Practice Address - Fax:804-594-1945
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-19
Last Update Date:2014-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0103300896213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA389911OtherANTHEM - RUSS
VA232349OtherSOUTHERN HEALTH
VAFIRST HEALTHOtherFIRST HEALTH
VA427297361OtherTRICARE
VA010049351Medicaid
VA7797532OtherAETNA
VA7330335OtherCIGNA
VA010136296Medicaid
VA160546960OtherTRICARE
VA2126938OtherMAMSI
VA3106155OtherCIGNA
VA=========OtherPHCS
VAP00294989Medicare ID - Type Unspecified
VA010136296Medicaid
VA389911OtherANTHEM - RUSS
VA7330335OtherCIGNA
VA7797532OtherAETNA
VA2126938OtherMAMSI
VAC09007Medicare ID - Type Unspecified
VA006554E07Medicare ID - Type Unspecified