Provider Demographics
NPI:1861446049
Name:NORTH WALES PODIATRY ASSOCS PC
Entity Type:Organization
Organization Name:NORTH WALES PODIATRY ASSOCS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ARTHUR
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:DONLEY
Authorized Official - Suffix:JR
Authorized Official - Credentials:DPM
Authorized Official - Phone:215-361-7848
Mailing Address - Street 1:1061 S BROAD ST
Mailing Address - Street 2:
Mailing Address - City:LANSDALE
Mailing Address - State:PA
Mailing Address - Zip Code:19446-5338
Mailing Address - Country:US
Mailing Address - Phone:215-361-7848
Mailing Address - Fax:
Practice Address - Street 1:1061 S BROAD ST
Practice Address - Street 2:
Practice Address - City:LANSDALE
Practice Address - State:PA
Practice Address - Zip Code:19446-5338
Practice Address - Country:US
Practice Address - Phone:215-361-7848
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-20
Last Update Date:2011-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASC002089L213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
130914Medicare ID - Type Unspecified
PA6483870001Medicare NSC