Provider Demographics
NPI:1285071704
Name:ADVANCED ANKLE AND FOOT CENTER, LLC
Entity type:Organization
Organization Name:ADVANCED ANKLE AND FOOT CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-864-9560
Mailing Address - Street 1:600 N PICKAWAY ST STE 107
Mailing Address - Street 2:MEDICAL OFFICE BUILDING
Mailing Address - City:CIRCLEVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43113-1447
Mailing Address - Country:US
Mailing Address - Phone:740-302-3668
Mailing Address - Fax:614-792-7615
Practice Address - Street 1:600 N PICKAWAY ST STE 107
Practice Address - Street 2:MEDICAL OFFICE BUILDING
Practice Address - City:CIRCLEVILLE
Practice Address - State:OH
Practice Address - Zip Code:43113-1447
Practice Address - Country:US
Practice Address - Phone:740-302-3668
Practice Address - Fax:614-792-7615
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-23
Last Update Date:2013-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty