National Provider Identifier Database

JACKSON FAMILY FOOT ANKLE CARE LLC
Surgery, Foot & Ankle


Contact Information

JACKSON FAMILY FOOT & ANKLE CARE, LLC
100 W VETERANS HWY
SUITE 11
JACKSON, NJ08527-3435
Phone: 732-833-6888
Fax: 732-833-6280
Website:
Specialty Taxonomy Code
* Surgery, Foot & Ankle 213ES0103X

* Indicates primary specialty

NPI Profile & details for JACKSON FAMILY FOOT & ANKLE CARE, LLC

NPI Number 1104025931
Legal business name
LBN
JACKSON FAMILY FOOT & ANKLE CARE, LLC
Authorized official CHRISTOPHER BLAKESLEE - (OWNER)
Entity Organization
Organization subpart No
Enumeration date 07/12/2007
Last updated 12/10/2010 - About 16 years ago
Sole proprietor1 Not specified
Identifiers
  • NJ License #: 25MD00263900
  • NJ Medicaid: 9052801

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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