Provider Demographics
NPI:1669564829
Name:RAPPAHANNOCK FOOT & ANKLE SPECIALISTS, PLC
Entity type:Organization
Organization Name:RAPPAHANNOCK FOOT & ANKLE SPECIALISTS, PLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:MATTHEW
Authorized Official - Last Name:CARLEY
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:540-371-2724
Mailing Address - Street 1:PO BOX 8389
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22404
Mailing Address - Country:US
Mailing Address - Phone:540-371-2724
Mailing Address - Fax:540-371-5072
Practice Address - Street 1:195 FALCON DRIVE
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22408
Practice Address - Country:US
Practice Address - Phone:540-371-2724
Practice Address - Fax:540-371-5072
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-28
Last Update Date:2024-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAC06376Medicare ID - Type UnspecifiedMEDICARE GROUP NUMBER
VA4692740001Medicare NSC