Provider Demographics
NPI:1790805695
Name:FAMILY FOOT AND ANKLE CARE, PC
Entity Type:Organization
Organization Name:FAMILY FOOT AND ANKLE CARE, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:LLOYD
Authorized Official - Last Name:VINCENT
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:540-667-3338
Mailing Address - Street 1:650 CEDAR CREEK GRADE STE 108
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:22601-6453
Mailing Address - Country:US
Mailing Address - Phone:540-667-3338
Mailing Address - Fax:540-667-1589
Practice Address - Street 1:650 CEDAR CREEK GRADE STE 108
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:VA
Practice Address - Zip Code:22601-6453
Practice Address - Country:US
Practice Address - Phone:540-667-3338
Practice Address - Fax:540-667-1589
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-02
Last Update Date:2024-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0103300898213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VADD1110OtherRAILROAD MEDICARE GROUP
VA010135541Medicaid
VA173121OtherANTHEM
VAP00209069OtherRAILROAD MEDICARE
VADD1110OtherRAILROAD MEDICARE GROUP
VAC09449Medicare PIN