National Provider Identifier Database

NESHOBA FOOT AND ANKLE CLINIC
Surgery, Foot & Ankle


Contact Information

NESHOBA FOOT AND ANKLE CLINIC
1003 HOLLAND AVE
SUITE 102
PHILADELPHIA, MS39350-2180
Phone: 601-663-1423
Fax: 601-663-1474
Website:
Specialty Taxonomy Code
* Surgery, Foot & Ankle 213ES0103X

* Indicates primary specialty

NPI Profile & details for NESHOBA FOOT AND ANKLE CLINIC

NPI Number 1013142017
Legal business name
LBN
NESHOBA FOOT AND ANKLE CLINIC
Authorized official STEPHANIE BUTLER - (CBO MANAGER)
Entity Organization
Organization subpart No
Enumeration date 05/19/2009
Last updated 05/19/2009 - About 17 years ago
Sole proprietor1 Not specified
Identifiers
  • MS License #: 80193

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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