Provider Demographics
NPI:1679326441
Name:ADVANCED FOOT AND ANKLE CENTERS INC
Entity Type:Organization
Organization Name:ADVANCED FOOT AND ANKLE CENTERS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:MS
Authorized Official - First Name:LISA
Authorized Official - Middle Name:
Authorized Official - Last Name:MERKOW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-239-3713
Mailing Address - Street 1:999 PINNACLE DR W
Mailing Address - Street 2:
Mailing Address - City:MADERA
Mailing Address - State:CA
Mailing Address - Zip Code:93636-8191
Mailing Address - Country:US
Mailing Address - Phone:520-861-6688
Mailing Address - Fax:
Practice Address - Street 1:1267 SHAW AVE, STE 115
Practice Address - Street 2:
Practice Address - City:CLOVIS
Practice Address - State:CA
Practice Address - Zip Code:93611
Practice Address - Country:US
Practice Address - Phone:727-239-3713
Practice Address - Fax:855-552-3776
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-10
Last Update Date:2024-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty