Provider Demographics
NPI:1770104903
Name:PRECISION PODIATRY SERVICES PLLC
Entity type:Organization
Organization Name:PRECISION PODIATRY SERVICES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:FADI
Authorized Official - Middle Name:
Authorized Official - Last Name:JAAFAR
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:313-203-6663
Mailing Address - Street 1:1469 MARY CT
Mailing Address - Street 2:
Mailing Address - City:ALMA
Mailing Address - State:MI
Mailing Address - Zip Code:48801-1053
Mailing Address - Country:US
Mailing Address - Phone:989-463-2150
Mailing Address - Fax:989-466-5392
Practice Address - Street 1:1469 MARY CT
Practice Address - Street 2:
Practice Address - City:ALMA
Practice Address - State:MI
Practice Address - Zip Code:48801-1053
Practice Address - Country:US
Practice Address - Phone:989-463-2150
Practice Address - Fax:989-466-5392
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-28
Last Update Date:2020-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric MedicineGroup - Single Specialty