Provider Demographics
NPI:1144578097
Name:WEBB FOOT AND ANKLE CLINIC PC
Entity Type:Organization
Organization Name:WEBB FOOT AND ANKLE CLINIC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PODIATRIST
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:CHRISTOPHER
Authorized Official - Last Name:WEBB
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:865-573-5551
Mailing Address - Street 1:811 MIDDLE CREEK RD
Mailing Address - Street 2:
Mailing Address - City:SEVIERVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37862-5018
Mailing Address - Country:US
Mailing Address - Phone:865-774-2292
Mailing Address - Fax:865-774-2243
Practice Address - Street 1:319 BLUE PEACOCK WAY
Practice Address - Street 2:SUITE 1
Practice Address - City:SEYMOUR
Practice Address - State:TN
Practice Address - Zip Code:37865-3924
Practice Address - Country:US
Practice Address - Phone:865-573-5551
Practice Address - Fax:865-573-5559
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-27
Last Update Date:2014-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDPM624332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN5503070002Medicare NSC