# FOOT FIRST PODIATRY

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

## Provider details

- **NPI number:** 1053658963
- **Authorized official:** DR. KELVIN DEVANE GIPSON DPM (OWNER)
- **Authorized official phone:** (407) 443-9784

## Contact information

- **Practice address:** 2600 HOSPITAL DR, BONIFAY, FL 32425-4264
- **Practice address phone:** (850) 547-8117
- **Practice address fax:** (850) 547-8090
- **Mailing address:** PO BOX 1199, DEFUNIAK SPRINGS, FL 32435-1199
- **Mailing address phone:** (407) 443-9784
- **Mailing address fax:** (850) 547-8090

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 213ES0103X | Foot & Ankle Surgery Podiatrist | PO 2195 | FL | Yes |

## Other

- **Enumeration date:** 01/11/2013
- **Last updated:** 01/11/2013