Provider Demographics
NPI:1629592191
Name:CHRISTIE FOOT & ANKLE, LLC
Entity Type:Organization
Organization Name:CHRISTIE FOOT & ANKLE, LLC
Other - Org Name:CHRISTIE FOOT AND ANKLE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SUE
Authorized Official - Middle Name:
Authorized Official - Last Name:MARTIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-884-9948
Mailing Address - Street 1:3031 MERIDIAN MEADOWS RD
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD
Mailing Address - State:IN
Mailing Address - Zip Code:46142-1011
Mailing Address - Country:US
Mailing Address - Phone:317-408-8400
Mailing Address - Fax:
Practice Address - Street 1:3031 MERIDIAN MEADOWS RD
Practice Address - Street 2:
Practice Address - City:GREENWOOD
Practice Address - State:IN
Practice Address - Zip Code:46142-1011
Practice Address - Country:US
Practice Address - Phone:317-408-8400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-27
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN07001177A213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty