Provider Demographics
NPI:1245500040
Name:SENECA FAMILY FOOT CARE, PLLC
Entity type:Organization
Organization Name:SENECA FAMILY FOOT CARE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GERALD
Authorized Official - Middle Name:MARSHALL
Authorized Official - Last Name:ERSKINE
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:304-645-0200
Mailing Address - Street 1:336 SENECA TRAIL
Mailing Address - Street 2:
Mailing Address - City:RONCEVERTE
Mailing Address - State:WV
Mailing Address - Zip Code:24970
Mailing Address - Country:US
Mailing Address - Phone:304-645-0200
Mailing Address - Fax:304-645-0240
Practice Address - Street 1:336 SENECA TRAIL
Practice Address - Street 2:
Practice Address - City:RONCEVERTE
Practice Address - State:WV
Practice Address - Zip Code:24970
Practice Address - Country:US
Practice Address - Phone:304-645-0200
Practice Address - Fax:304-645-0240
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-10
Last Update Date:2013-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV00350213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot SurgeryGroup - Single Specialty