| NPI | 1295407922 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEVION SMITH Director, Payer Contracting 424-326-8711 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213EP0504X Podiatrist, Public Medicine |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
| 207R00000X Internal Medicine | |
| 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery | |
| 2086S0129X Surgery, Vascular Surgery | |
| 213E00000X Podiatrist | |
| 213ES0103X Podiatrist, Foot & Ankle Surgery | |
| Enumeration Date | 2021-09-30 |
| Last Update Date | 2022-11-14 |