Provider Demographics
NPI:1114105210
Name:ANKLE AND FOOT CLINIC OF ERIE PC
Entity Type:Organization
Organization Name:ANKLE AND FOOT CLINIC OF ERIE PC
Other - Org Name:AMERICAN PODIATRY CENTERS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DPM
Authorized Official - Prefix:DR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:E
Authorized Official - Last Name:MUSSETT
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:814-868-2590
Mailing Address - Street 1:3737 W 26TH ST
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16506-2038
Mailing Address - Country:US
Mailing Address - Phone:814-835-3800
Mailing Address - Fax:814-835-3808
Practice Address - Street 1:3737 W 26TH ST
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16506-2038
Practice Address - Country:US
Practice Address - Phone:814-835-3800
Practice Address - Fax:814-835-3808
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-31
Last Update Date:2010-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA4393540001Medicare NSC
PAU66355Medicare UPIN
PA122642Medicare PIN
PA951467XITMedicare PIN