Provider Demographics
NPI:1992981492
Name:OAKTON FOOT AND ANKLE CENTER PLLC
Entity type:Organization
Organization Name:OAKTON FOOT AND ANKLE CENTER PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SOLE PROPRIETOR
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:R
Authorized Official - Last Name:VETTER
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:703-352-8888
Mailing Address - Street 1:10721 MAIN ST
Mailing Address - Street 2:SUITE 3500
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22030-6914
Mailing Address - Country:US
Mailing Address - Phone:703-352-8888
Mailing Address - Fax:703-352-8994
Practice Address - Street 1:10721 MAIN ST STE 3500
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22030-6909
Practice Address - Country:US
Practice Address - Phone:703-352-8888
Practice Address - Fax:703-352-8994
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-14
Last Update Date:2021-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
213ES0103X, 261QP1100X
VA0130000659332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
No261QP1100XAmbulatory Health Care FacilitiesClinic/CenterPodiatric
No332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0479150001Medicare NSC