Provider Demographics
NPI:1093549230
Name:POCONO FOOT & ANKLE CONSULTANTS, P.C.
Entity type:Organization
Organization Name:POCONO FOOT & ANKLE CONSULTANTS, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE BUSINESS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JOANN
Authorized Official - Middle Name:
Authorized Official - Last Name:JAGGARD-LIM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:705-517-7166
Mailing Address - Street 1:411 DOGWOOD RD
Mailing Address - Street 2:
Mailing Address - City:STROUDSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:18360-7566
Mailing Address - Country:US
Mailing Address - Phone:570-517-7166
Mailing Address - Fax:
Practice Address - Street 1:1901 HAY TER STE 7
Practice Address - Street 2:
Practice Address - City:EASTON
Practice Address - State:PA
Practice Address - Zip Code:18042-4650
Practice Address - Country:US
Practice Address - Phone:570-476-6629
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-29
Last Update Date:2024-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty