Provider Demographics
NPI:1700175403
Name:MOSES CONE AFFILIATED PHYSICIANS, INC.
Entity Type:Organization
Organization Name:MOSES CONE AFFILIATED PHYSICIANS, INC.
Other - Org Name:GUILFORD FOOT CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO AND TREASURER
Authorized Official - Prefix:
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:KNIGHT
Authorized Official - Last Name:BOGGS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-832-8005
Mailing Address - Street 1:3931 TINSLEY DRIVE
Mailing Address - Street 2:SUITE 104
Mailing Address - City:HIGH POINT
Mailing Address - State:NC
Mailing Address - Zip Code:27265-1533
Mailing Address - Country:US
Mailing Address - Phone:336-282-8787
Mailing Address - Fax:336-510-7284
Practice Address - Street 1:3931 TINSLEY DRIVE
Practice Address - Street 2:SUITE 104
Practice Address - City:HIGH POINT
Practice Address - State:NC
Practice Address - Zip Code:27265-1533
Practice Address - Country:US
Practice Address - Phone:336-282-8787
Practice Address - Fax:336-510-7284
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THE MOSES H. CONE MEMORIAL HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-04-04
Last Update Date:2011-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Multi-Specialty
No213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Multi-Specialty