BRUNSWICK FOOT & ANKLE SURGERY NPI 1396874285

NPI Information

NPI: 1396874285
Provider Name: BRUNSWICK FOOT & ANKLE SURGERY
Classification: Clinic/Center - 261QP1100X
Entity Type: Organization

Specialization: Podiatric

Address:
14 DOCTORS CIR
SUITE 2
SUPPLY, NC
ZIP 28462
Phone: (919) 751-9120
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BRUNSWICK FOOT & ANKLE SURGERY is a podiatric clinic center in Supply, NC. BRUNSWICK FOOT & ANKLE SURGERY NPI is 1396874285. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

14 DOCTORS CIR
SUITE 2
SUPPLY, NC
ZIP 28462-097
Phone: (919) 751-9120
Fax: (919) 751-9170

The provider's authorized official is Joseph Kibler .
The authorized official title is Owner and has the following contact phone number (919) 751-9120.

The enumeration date for this NPI number is 3/5/2007 and was last updated on 9/21/2011.

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
1	213ES0103X	Podiatrist	Foot & Ankle Surgery	452	NORTH CAROLINA	No
2	261QP1100X	Clinic/Center	Podiatric			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	5199990001	OTHER	NORTH CAROLINA	MEDICARE DMERC PTAN
2	U87970	MEDICARE UPIN	NORTH CAROLINA
3	5199990001	MEDICARE NSC	NORTH CAROLINA
4	890806X	MEDICAID	NORTH CAROLINA
5	2339324	MEDICARE PIN	NORTH CAROLINA

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: 11/14/2023

NPI Synchronization or Removal

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