Provider Demographics
NPI:1164249918
Name:SOLE SKIN & FOOT SPECIALISTS, PLLC
Entity type:Organization
Organization Name:SOLE SKIN & FOOT SPECIALISTS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ DIRECTOR/ DNP
Authorized Official - Prefix:DR
Authorized Official - First Name:MORGAN
Authorized Official - Middle Name:
Authorized Official - Last Name:WOMBLE
Authorized Official - Suffix:
Authorized Official - Credentials:DNP
Authorized Official - Phone:919-619-6622
Mailing Address - Street 1:1135 SMITH LEVEL RD
Mailing Address - Street 2:
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27516-3137
Mailing Address - Country:US
Mailing Address - Phone:919-619-6622
Mailing Address - Fax:
Practice Address - Street 1:1135 SMITH LEVEL RD
Practice Address - Street 2:
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27516-3137
Practice Address - Country:US
Practice Address - Phone:919-619-6622
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-23
Last Update Date:2024-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty