Provider Demographics
NPI:1902376346
Name:FAMILY FOOT AND ANKLE PLLC
Entity Type:Organization
Organization Name:FAMILY FOOT AND ANKLE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL BILLER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SUSIE
Authorized Official - Middle Name:
Authorized Official - Last Name:FABYUNKEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:931-528-1331
Mailing Address - Street 1:120 WALNUT COMMONS LN STE A
Mailing Address - Street 2:
Mailing Address - City:COOKEVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38501-6037
Mailing Address - Country:US
Mailing Address - Phone:931-528-1331
Mailing Address - Fax:931-528-6893
Practice Address - Street 1:120 WALNUT COMMONS LN STE A120
Practice Address - Street 2:
Practice Address - City:COOKEVILLE
Practice Address - State:TN
Practice Address - Zip Code:38501-6035
Practice Address - Country:US
Practice Address - Phone:931-528-1331
Practice Address - Fax:931-528-6893
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-28
Last Update Date:2018-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty