Provider Demographics
NPI:1417173972
Name:FOOT HEALTH CENTER,PC
Entity Type:Organization
Organization Name:FOOT HEALTH CENTER,PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PODIATRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:
Authorized Official - Last Name:LYNN
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:865-481-3338
Mailing Address - Street 1:659 EMORY VALLEY RD STE C
Mailing Address - Street 2:
Mailing Address - City:OAK RIDGE
Mailing Address - State:TN
Mailing Address - Zip Code:37830-7764
Mailing Address - Country:US
Mailing Address - Phone:865-481-3338
Mailing Address - Fax:865-481-0477
Practice Address - Street 1:659 EMORY VALLEY RD STE C
Practice Address - Street 2:
Practice Address - City:OAK RIDGE
Practice Address - State:TN
Practice Address - Zip Code:37830-7764
Practice Address - Country:US
Practice Address - Phone:865-481-3338
Practice Address - Fax:865-481-0477
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-17
Last Update Date:2008-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN2366703OtherCIGNA HEALTHCARE
TN3011580OtherBLUECROSS BLUESHIELD
TN3729302Medicaid
TN4065733OtherAETNA
TN2740012OtherUNITED HEALTHCARE
TN4065733OtherAETNA
TNT61115Medicare UPIN
TN1171070001Medicare NSC