Provider Demographics
NPI:1174350805
Name:PREMIER FOOT AND ANKLE PLLC
Entity type:Organization
Organization Name:PREMIER FOOT AND ANKLE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:KIMBERLEE
Authorized Official - Middle Name:BROOKE
Authorized Official - Last Name:HOBIZAL
Authorized Official - Suffix:
Authorized Official - Credentials:DPM, MHA
Authorized Official - Phone:515-664-2827
Mailing Address - Street 1:2620 CONSTITUTION BLVD STE 104
Mailing Address - Street 2:
Mailing Address - City:BEAVER FALLS
Mailing Address - State:PA
Mailing Address - Zip Code:15010-1278
Mailing Address - Country:US
Mailing Address - Phone:412-830-7837
Mailing Address - Fax:412-909-4168
Practice Address - Street 1:2620 CONSTITUTION BLVD STE 104
Practice Address - Street 2:
Practice Address - City:BEAVER FALLS
Practice Address - State:PA
Practice Address - Zip Code:15010-1278
Practice Address - Country:US
Practice Address - Phone:412-830-7837
Practice Address - Fax:412-909-4168
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-17
Last Update Date:2024-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty