Provider Demographics
NPI:1649862293
Name:ASSOCIATED FOOT & ANKLE SPECIALISTS LLC
Entity type:Organization
Organization Name:ASSOCIATED FOOT & ANKLE SPECIALISTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DRENNAN
Authorized Official - Middle Name:L
Authorized Official - Last Name:JOSEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:843-356-9673
Mailing Address - Street 1:966 HARBOR OAKS DR
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29412-4352
Mailing Address - Country:US
Mailing Address - Phone:843-356-9673
Mailing Address - Fax:
Practice Address - Street 1:2097 HENRY TECKLENBURG DR
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29414-5740
Practice Address - Country:US
Practice Address - Phone:843-356-9673
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-05
Last Update Date:2021-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty