Provider Demographics
NPI:1952722910
Name:ROCKINGHAM FOOT & ANKLE ASSOCIATES
Entity Type:Organization
Organization Name:ROCKINGHAM FOOT & ANKLE ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BENJAMIN
Authorized Official - Middle Name:
Authorized Official - Last Name:MCKINNEY
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:336-342-5701
Mailing Address - Street 1:100 VICAR PL
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24540-1396
Mailing Address - Country:US
Mailing Address - Phone:434-836-3338
Mailing Address - Fax:434-836-3330
Practice Address - Street 1:100 VICAR PL
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:VA
Practice Address - Zip Code:24540-1396
Practice Address - Country:US
Practice Address - Phone:434-836-3338
Practice Address - Fax:434-836-3330
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-18
Last Update Date:2014-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1952722910Medicaid
VA1952722910Medicaid
VA7193950001Medicare NSC