Provider Demographics
NPI:1518390335
Name:THE FOOT DOCTORS & WOUND CARE SPECIALISTS PC
Entity Type:Organization
Organization Name:THE FOOT DOCTORS & WOUND CARE SPECIALISTS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LYNN
Authorized Official - Middle Name:
Authorized Official - Last Name:BANKERT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:856-393-8771
Mailing Address - Street 1:64 VILLAGE DR
Mailing Address - Street 2:
Mailing Address - City:BARNEGAT
Mailing Address - State:NJ
Mailing Address - Zip Code:08005-1671
Mailing Address - Country:US
Mailing Address - Phone:856-393-8771
Mailing Address - Fax:856-393-8767
Practice Address - Street 1:8008 ROUTE 130
Practice Address - Street 2:SUITE 310
Practice Address - City:DELRAN
Practice Address - State:NJ
Practice Address - Zip Code:08075-1869
Practice Address - Country:US
Practice Address - Phone:856-393-8771
Practice Address - Fax:856-393-8767
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-15
Last Update Date:2013-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP1100XAmbulatory Health Care FacilitiesClinic/CenterPodiatric