JACKSON FAMILY FOOT & ANKLE CARE, LLC; NPI #1104025931

Contact Information

JACKSON FAMILY FOOT & ANKLE CARE, LLC

100 W VETERANS HWY
SUITE 11
JACKSON, NJ 08527-3435

Phone: 732-833-6888
Fax: 732-833-6280
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Surgery, Foot & Ankle	213ES0103X	48	Podiatry

Indicates primary specialty

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

NPI # 1104025931

LBN Legal business name JACKSON FAMILY FOOT & ANKLE CARE, LLC

Authorized official CHRISTOPHER BLAKESLEE - (OWNER)

Entity Organization

Organization subpart ¹ No

Enumeration date 07/12/2007

Last updated 12/10/2010 - About 16 years ago

Identifiers

NJ	License #	25MD00263900
NJ	Medicaid	9052801

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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