Provider Demographics
NPI:1902082423
Name:ACHILLES FOOT ANKLE CENTER INC
Entity Type:Organization
Organization Name:ACHILLES FOOT ANKLE CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:B
Authorized Official - Last Name:BALDWIN
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:804-273-1717
Mailing Address - Street 1:7660 E PARHAM RD
Mailing Address - Street 2:SUITE 107
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23294-4378
Mailing Address - Country:US
Mailing Address - Phone:804-273-1717
Mailing Address - Fax:804-273-1834
Practice Address - Street 1:7660 E PARHAM RD
Practice Address - Street 2:SUITE 107
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23294-4378
Practice Address - Country:US
Practice Address - Phone:804-273-1717
Practice Address - Fax:804-273-1834
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-15
Last Update Date:2017-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0103301127213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA6147850001Medicare NSC
VAC10425Medicare PIN
VA1508835315OtherPHYSICIAN NPI NUMBER