Provider Demographics
NPI:1518452143
Name:FOOT AND ANKLE ASSOCIATES OF NC, PLLC
Entity Type:Organization
Organization Name:FOOT AND ANKLE ASSOCIATES OF NC, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CLARENCE
Authorized Official - Middle Name:M
Authorized Official - Last Name:STEWART
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:919-231-7969
Mailing Address - Street 1:PO BOX 14759
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27620-4759
Mailing Address - Country:US
Mailing Address - Phone:919-231-7969
Mailing Address - Fax:919-231-7970
Practice Address - Street 1:2130 FOREST HILLS RD W STE C
Practice Address - Street 2:
Practice Address - City:WILSON
Practice Address - State:NC
Practice Address - Zip Code:27893-3681
Practice Address - Country:US
Practice Address - Phone:252-281-4442
Practice Address - Fax:252-281-4439
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-26
Last Update Date:2022-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty