Provider Demographics
NPI:1821645987
Name:GATEWAY FOOT AND ANKLE CENTER, PLC
Entity Type:Organization
Organization Name:GATEWAY FOOT AND ANKLE CENTER, PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:E
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:931-245-1920
Mailing Address - Street 1:647 DUNLOP LANE
Mailing Address - Street 2:SUTIE 209
Mailing Address - City:CLARKSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37040
Mailing Address - Country:US
Mailing Address - Phone:615-851-0144
Mailing Address - Fax:615-851-0144
Practice Address - Street 1:4230 HARDING PIKE
Practice Address - Street 2:SUITE G12
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37205
Practice Address - Country:US
Practice Address - Phone:615-301-7054
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GATEWAY FOOT AND ANKLE CENTER, PLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-08-23
Last Update Date:2019-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Multi-Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No335E00000XSuppliersProsthetic/Orthotic SupplierGroup - Multi-Specialty