Provider Demographics
NPI:1386853760
Name:NORTHERN FOOT & ANKLE ASSOCIATES PA
Entity Type:Organization
Organization Name:NORTHERN FOOT & ANKLE ASSOCIATES PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:CURT
Authorized Official - Middle Name:A
Authorized Official - Last Name:KRISTENSEN
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:218-722-0615
Mailing Address - Street 1:324 W SUPERIOR ST STE 408
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55802-1726
Mailing Address - Country:US
Mailing Address - Phone:218-722-0615
Mailing Address - Fax:
Practice Address - Street 1:324 W SUPERIOR ST STE 408
Practice Address - Street 2:
Practice Address - City:DULUTH
Practice Address - State:MN
Practice Address - Zip Code:55802-1726
Practice Address - Country:US
Practice Address - Phone:218-722-0615
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-22
Last Update Date:2013-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN482213ES0103X
MN496213ES0103X
MN498213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN0726160002Medicare NSC