Provider Demographics
NPI:1194371161
Name:NORTH SHORE FOOT & ANKLE CARE
Entity Type:Organization
Organization Name:NORTH SHORE FOOT & ANKLE CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CHESTER
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:III
Authorized Official - Credentials:DPM
Authorized Official - Phone:888-212-4243
Mailing Address - Street 1:2101 SHANNON OXMOOR RD # 82
Mailing Address - Street 2:
Mailing Address - City:SHANNON
Mailing Address - State:AL
Mailing Address - Zip Code:35142-2000
Mailing Address - Country:US
Mailing Address - Phone:888-212-4243
Mailing Address - Fax:205-847-5262
Practice Address - Street 1:2960 S SHEPHERDS GLN
Practice Address - Street 2:
Practice Address - City:WICHITA FALLS
Practice Address - State:TX
Practice Address - Zip Code:76308-5449
Practice Address - Country:US
Practice Address - Phone:888-212-4242
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-14
Last Update Date:2020-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty