Provider Demographics
NPI:1174714505
Name:UNIVERSITY FOOT AND ANKLE CENTERS, LLC
Entity type:Organization
Organization Name:UNIVERSITY FOOT AND ANKLE CENTERS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:D
Authorized Official - Last Name:POOLE
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:615-790-3323
Mailing Address - Street 1:100 COVEY DR
Mailing Address - Street 2:SUITE 309
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37067-5665
Mailing Address - Country:US
Mailing Address - Phone:615-790-3323
Mailing Address - Fax:615-790-6331
Practice Address - Street 1:100 COVEY DR
Practice Address - Street 2:SUITE 309
Practice Address - City:FRANKLIN
Practice Address - State:TN
Practice Address - Zip Code:37067-5665
Practice Address - Country:US
Practice Address - Phone:615-790-3323
Practice Address - Fax:615-790-6331
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-09
Last Update Date:2024-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN632213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1114967684OtherNPI
TN4107160OtherBLUE CROSS BLUE SHIELD
TNP00310830OtherMEDICARE RET RAIL
TNP00280404OtherMEDICARE RET RAIL
TN10069451OtherAMERIGROUP
TN1174714505OtherNPI
TN3730128Medicaid
TN7783722OtherAETNA
TN1003855537OtherNPI
TNDE2412OtherMEDICARE RETIRED RAILROAD
TN4107107OtherBLUE CROSS BLUE SHIELD
TN7994743OtherAETNA
TN7783722OtherAETNA
TN3730128Medicare PIN