AMBULATORY FOOT CENTER PC NPI 1063630291

NPI Information

  • NPI: 1063630291
  • Provider Name: AMBULATORY FOOT CENTER PC
  • Classification: Podiatrist - 213ES0103X
  • Specialization: Foot & Ankle Surgery
  • Entity Type: Organization
  • Address: 1619 NW HAWTHORNE AVE STE 110
    GRANTS PASS, OR
    ZIP 97526
  • Phone: (541) 471-7056

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NPI Details

AMBULATORY FOOT CENTER PC is a foot and ankle surgery podiatrist in Grants Pass, OR. AMBULATORY FOOT CENTER PC NPI is 1063630291. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1619 NW HAWTHORNE AVE STE 110
GRANTS PASS, OR
ZIP 97526-008
Phone: (541) 471-7056

The provider's authorized official is Mark L Simchuk .
The authorized official title is Excutive Officer and has the following contact phone number (541) 471-7056.

The enumeration date for this NPI number is 4/23/2007 and was last updated on 10/29/2025.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1213ES0103XPodiatristFoot & Ankle SurgeryDP00291OREGONYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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