Provider Demographics
NPI:1710425582
Name:FOOT AND ANKLE SPECIALISTS OF BUCKS COUNTY, LLC
Entity Type:Organization
Organization Name:FOOT AND ANKLE SPECIALISTS OF BUCKS COUNTY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MITCHELL
Authorized Official - Middle Name:D
Authorized Official - Last Name:KAHN
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:215-245-1818
Mailing Address - Street 1:PO BOX 12
Mailing Address - Street 2:
Mailing Address - City:FEASTERVILLE TREVOSE
Mailing Address - State:PA
Mailing Address - Zip Code:19053-0012
Mailing Address - Country:US
Mailing Address - Phone:215-946-3338
Mailing Address - Fax:215-946-1022
Practice Address - Street 1:360 NORTH OXFORD VALLEY RD
Practice Address - Street 2:
Practice Address - City:LANGHORNE
Practice Address - State:PA
Practice Address - Zip Code:19047-8302
Practice Address - Country:US
Practice Address - Phone:215-946-3338
Practice Address - Fax:215-946-1022
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FOOT AND ANKLE SPECIALISTS OF BUCKS COUNTY, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-02-01
Last Update Date:2018-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty