Provider Demographics
NPI:1790785392
Name:ANKLE AND FOOT ASSOCIATES
Entity Type:Organization
Organization Name:ANKLE AND FOOT ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:DEBBIE
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:MONKS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:814-849-2073
Mailing Address - Street 1:73 S WHITE ST
Mailing Address - Street 2:
Mailing Address - City:BROOKVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15825-2427
Mailing Address - Country:US
Mailing Address - Phone:814-849-2073
Mailing Address - Fax:814-849-8282
Practice Address - Street 1:50 S WHITE ST
Practice Address - Street 2:
Practice Address - City:BROOKVILLE
Practice Address - State:PA
Practice Address - Zip Code:15825-2424
Practice Address - Country:US
Practice Address - Phone:814-849-2073
Practice Address - Fax:814-849-8282
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-26
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA213E00000X, 213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
No213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1007443290005Medicaid
PA1007443290005Medicaid