Provider Demographics
NPI:1306807961
Name:FRANKLIN COUNTY FOOT & ANKLE CENTER LLC
Entity type:Organization
Organization Name:FRANKLIN COUNTY FOOT & ANKLE CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:S
Authorized Official - Last Name:JACKO
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:717-762-6300
Mailing Address - Street 1:1905 MARKET SQUARE BLVD
Mailing Address - Street 2:
Mailing Address - City:WAYNESBORO
Mailing Address - State:PA
Mailing Address - Zip Code:17268-3811
Mailing Address - Country:US
Mailing Address - Phone:717-762-6300
Mailing Address - Fax:717-762-1831
Practice Address - Street 1:1905 MARKET SQUARE BLVD
Practice Address - Street 2:
Practice Address - City:WAYNESBORO
Practice Address - State:PA
Practice Address - Zip Code:17268-3811
Practice Address - Country:US
Practice Address - Phone:717-762-6300
Practice Address - Fax:717-762-1831
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-31
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1265401707OtherNPI
PA1902875446OtherNPI
PA1277250001Medicare NSC
PAU90387Medicare UPIN
PA1902875446OtherNPI