Provider Demographics
NPI:1568533164
Name:WHITE ROSE FOOT AND ANKLE, PC
Entity Type:Organization
Organization Name:WHITE ROSE FOOT AND ANKLE, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DANA
Authorized Official - Middle Name:N
Authorized Official - Last Name:LINN
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:717-870-9926
Mailing Address - Street 1:1880 KENNETH RD
Mailing Address - Street 2:SUITE 3
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17404-6344
Mailing Address - Country:US
Mailing Address - Phone:717-870-9926
Mailing Address - Fax:717-764-3618
Practice Address - Street 1:1565 COPENHAFFER RD
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:PA
Practice Address - Zip Code:17315-1844
Practice Address - Country:US
Practice Address - Phone:717-870-9926
Practice Address - Fax:717-764-3618
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-13
Last Update Date:2007-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASC005717213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1016807180001Medicaid
PA1016807180001Medicaid