Provider Demographics
NPI:1558824631
Name:FOOT & ANKLE ASSOCIATES OF SOUTHERN NH, PLLC
Entity Type:Organization
Organization Name:FOOT & ANKLE ASSOCIATES OF SOUTHERN NH, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DREW
Authorized Official - Middle Name:
Authorized Official - Last Name:TAFT
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:603-401-7842
Mailing Address - Street 1:6 TSIENNETO RD STE 303
Mailing Address - Street 2:
Mailing Address - City:DERRY
Mailing Address - State:NH
Mailing Address - Zip Code:03038-1584
Mailing Address - Country:US
Mailing Address - Phone:603-432-2508
Mailing Address - Fax:
Practice Address - Street 1:6 TSIENNETO RD STE 303
Practice Address - Street 2:
Practice Address - City:DERRY
Practice Address - State:NH
Practice Address - Zip Code:03038-1584
Practice Address - Country:US
Practice Address - Phone:603-432-2508
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-07
Last Update Date:2019-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty