Provider Demographics
NPI:1023034576
Name:FOOT & ANKLE INSTITUTE OF KNOXVILLE, PLLC
Entity type:Organization
Organization Name:FOOT & ANKLE INSTITUTE OF KNOXVILLE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAGON
Authorized Official - Middle Name:J
Authorized Official - Last Name:PERCER
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:865-671-2760
Mailing Address - Street 1:116 CONCORD RD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37934-2940
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:116 CONCORD RD
Practice Address - Street 2:SUITE 300
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37934-2940
Practice Address - Country:US
Practice Address - Phone:865-671-2760
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-15
Last Update Date:2009-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDPM659261QP1100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP1100XAmbulatory Health Care FacilitiesClinic/CenterPodiatric
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1265467922OtherNPI # FOR DAGON J. PERCER