# NESHOBA FOOT AND ANKLE CLINIC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1013142017
- **Authorized official:** MRS. STEPHANIE BUTLER (CBO MANAGER)
- **Authorized official phone:** (601) 663-1423

## Contact information

- **Practice address:** 1003 HOLLAND AVE, SUITE 102, PHILADELPHIA, MS 39350-2180
- **Practice address phone:** (601) 663-1423
- **Practice address fax:** (601) 663-1474
- **Mailing address:** 1003 HOLLAND AVE, SUITE 102, PHILADELPHIA, MS 39350-2180
- **Mailing address phone:** (601) 663-1423
- **Mailing address fax:** (601) 663-1474

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 213ES0103X | Foot & Ankle Surgery Podiatrist | 80193 | MS | Yes |

## Other

- **Enumeration date:** 05/19/2009
- **Last updated:** 05/19/2009