Provider Demographics
NPI:1356386841
Name:ATLANTIC FOOT AND ANKLE CENTER
Entity type:Organization
Organization Name:ATLANTIC FOOT AND ANKLE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:HENRY
Authorized Official - Last Name:SIMON
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:757-481-0898
Mailing Address - Street 1:1788 REPUBLIC RD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23454-4552
Mailing Address - Country:US
Mailing Address - Phone:757-481-0898
Mailing Address - Fax:757-481-2563
Practice Address - Street 1:1788 REPUBLIC RD
Practice Address - Street 2:SUITE 300
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23454-4552
Practice Address - Country:US
Practice Address - Phone:757-481-0898
Practice Address - Fax:757-481-2563
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty