Provider Demographics
NPI:1770104994
Name:PRECISION PODIATRY PLLC
Entity type:Organization
Organization Name:PRECISION PODIATRY 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:313-203-6002
Mailing Address - Street 1:917 N LAFAYETTE ST
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48838-1129
Mailing Address - Country:US
Mailing Address - Phone:616-754-9580
Mailing Address - Fax:616-754-9519
Practice Address - Street 1:917 N LAFAYETTE ST
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:MI
Practice Address - Zip Code:48838-1129
Practice Address - Country:US
Practice Address - Phone:616-754-9580
Practice Address - Fax:616-754-9519
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-28
Last Update Date:2024-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric MedicineGroup - Single Specialty