Provider Demographics
NPI:1649365057
Name:NEUHAUS FOOT AND ANKLE, PC
Entity type:Organization
Organization Name:NEUHAUS FOOT AND ANKLE, PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN SOLE PROPRIETOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:D
Authorized Official - Last Name:NEUHAUS
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:615-220-8788
Mailing Address - Street 1:300 STONECREST BLVD
Mailing Address - Street 2:SUITE 350
Mailing Address - City:SMYRNA
Mailing Address - State:TN
Mailing Address - Zip Code:37167-5688
Mailing Address - Country:US
Mailing Address - Phone:615-220-8788
Mailing Address - Fax:615-768-7881
Practice Address - Street 1:300 STONECREST BLVD
Practice Address - Street 2:SUITE 350
Practice Address - City:SMYRNA
Practice Address - State:TN
Practice Address - Zip Code:37167-5688
Practice Address - Country:US
Practice Address - Phone:615-220-8788
Practice Address - Fax:615-768-7881
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-03
Last Update Date:2007-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDPM609174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3353883Medicaid
TNP00320782OtherMEDICARE RRB
TN5556260001Medicare NSC
TNP00320782OtherMEDICARE RRB
TN3353883Medicare PIN