Provider Demographics
NPI:1376988071
Name:PREMIER FOOT & ANKLE, PLLC
Entity Type:Organization
Organization Name:PREMIER FOOT & ANKLE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JARYL
Authorized Official - Middle Name:
Authorized Official - Last Name:KORPINEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-424-8999
Mailing Address - Street 1:6309 PRESTON RD
Mailing Address - Street 2:SUITE 1200
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75024-2738
Mailing Address - Country:US
Mailing Address - Phone:972-424-8999
Mailing Address - Fax:972-612-3926
Practice Address - Street 1:6309 PRESTON RD
Practice Address - Street 2:SUITE 1200
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75024-2738
Practice Address - Country:US
Practice Address - Phone:972-424-8999
Practice Address - Fax:972-612-3926
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-08
Last Update Date:2013-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1539213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty