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Contact Information

ADVANCED FOOT & ANKLE CENTER, LLC
9 AIRPORT RD
BLACKFOOT, ID83221-1702
 Phone: 208-785-6700
 Fax: 208-785-6767
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Podiatrist

213E00000X 48 Podiatry
Indicates primary specialty

NPI Profile & details for ADVANCED FOOT ANKLE CENTER LLC · (Female)

NPI # 1285947705
Status Active
Credentials
Entity Individual
Enumeration date 07/26/2010
Last updated 08/06/2021 - About 5 years ago
Sole proprietor 1 Not specified
Identifiers
  • ID License # P156
  • ID Medicaid 804309300
  • ID Other P1571 BLUE CROSS
  • ID Other 000010015672 BLUE SHIELD
  • ID Other 341488 DMBA
  • ID Other 461973001 DMERC
  • ID Other 480034721 MEDICARE RAILROAD
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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