Provider Demographics
NPI:1689441578
Name:ADVANCED ANKLE & FOOT CENTER
Entity Type:Organization
Organization Name:ADVANCED ANKLE & FOOT CENTER
Other - Org Name:ADVANCED ANKLE & FOOT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:J
Authorized Official - Last Name:SCHOPPE
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:762-850-8870
Mailing Address - Street 1:1544 GLENCOE DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31904-1904
Mailing Address - Country:US
Mailing Address - Phone:772-834-4296
Mailing Address - Fax:
Practice Address - Street 1:113 BASCOM CT STE B
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31909-2798
Practice Address - Country:US
Practice Address - Phone:762-850-8870
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-11
Last Update Date:2024-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty