Provider Demographics
NPI:1073713053
Name:DUNN FOOT & ANKLE CENTER, P.A.
Entity Type:Organization
Organization Name:DUNN FOOT & ANKLE CENTER, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PODIATRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:G
Authorized Official - Last Name:BASS
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:910-892-3338
Mailing Address - Street 1:303 TILGHMAN DR
Mailing Address - Street 2:
Mailing Address - City:DUNN
Mailing Address - State:NC
Mailing Address - Zip Code:28334-5524
Mailing Address - Country:US
Mailing Address - Phone:910-892-3338
Mailing Address - Fax:910-892-2706
Practice Address - Street 1:303 TILGHMAN DR
Practice Address - Street 2:
Practice Address - City:DUNN
Practice Address - State:NC
Practice Address - Zip Code:28334-5524
Practice Address - Country:US
Practice Address - Phone:910-892-3338
Practice Address - Fax:910-892-2706
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-19
Last Update Date:2008-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC223213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC890141FMedicaid
NC0141FOtherBCBS
NC1207270001Medicare NSC
NC2432760Medicare PIN
NC480019889Medicare PIN
NC2430193BMedicare PIN