Provider Demographics
NPI:1861857807
Name:ACADIA FOOT & ANKLE, PA
Entity Type:Organization
Organization Name:ACADIA FOOT & ANKLE, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ADAM
Authorized Official - Middle Name:
Authorized Official - Last Name:DARCY
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:207-947-2220
Mailing Address - Street 1:33 PENN PLZ STE A
Mailing Address - Street 2:
Mailing Address - City:BANGOR
Mailing Address - State:ME
Mailing Address - Zip Code:04401-3619
Mailing Address - Country:US
Mailing Address - Phone:207-947-2220
Mailing Address - Fax:207-947-4073
Practice Address - Street 1:33 PENN PLZ STE A
Practice Address - Street 2:
Practice Address - City:BANGOR
Practice Address - State:ME
Practice Address - Zip Code:04401-3619
Practice Address - Country:US
Practice Address - Phone:207-947-2220
Practice Address - Fax:207-947-4073
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-17
Last Update Date:2015-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MM9212Medicare PIN