Provider Demographics
NPI:1508960147
Name:FOOT & ANKLE HEALTH CENTER PC
Entity Type:Organization
Organization Name:FOOT & ANKLE HEALTH CENTER PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:D
Authorized Official - Last Name:POSS
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:561-499-5757
Mailing Address - Street 1:4800 LINTON BLVD
Mailing Address - Street 2:SUITE 301 BLDG E
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33445-6584
Mailing Address - Country:US
Mailing Address - Phone:561-499-5757
Mailing Address - Fax:561-865-2225
Practice Address - Street 1:30931 7 MILE RD
Practice Address - Street 2:
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48152-3366
Practice Address - Country:US
Practice Address - Phone:248-478-1166
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-12
Last Update Date:2007-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0P37320Medicare PIN