Provider Demographics
NPI:1821613399
Name:THE FOOT AND ANKLE CLINIC OF ALBUQUERQUE, P.C.
Entity Type:Organization
Organization Name:THE FOOT AND ANKLE CLINIC OF ALBUQUERQUE, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOOT AND ANKLE SURGEON
Authorized Official - Prefix:DR
Authorized Official - First Name:UCHENNA
Authorized Official - Middle Name:
Authorized Official - Last Name:CHUKWURAH
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:505-550-0858
Mailing Address - Street 1:717 ENCINO PL NE STE 3
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87102-2623
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:717 ENCINO PL NE STE 3
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87102-2623
Practice Address - Country:US
Practice Address - Phone:505-550-0858
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-10
Last Update Date:2020-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty