# FIRST STATE FOOT & ANKLE, LLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

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

## Provider details

- **NPI number:** 1154344422
- **Authorized official:** HEATHER HOLVECK (OFFICE MANAGER)
- **Authorized official phone:** (302) 984-0257

## Contact information

- **Practice address:** 4512 KIRKWOOD HIGHWAY SUITE 203, WILMINGTON, DE 19808
- **Practice address phone:** (302) 984-0257
- **Practice address fax:** (302) 984-0258
- **Mailing address:** 4512 KIRKWOOD HIGHWAY SUITE 203, WILMINGTON, DE 19808
- **Mailing address phone:** (302) 984-0257
- **Mailing address fax:** (302) 984-0258

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 213ES0103X | Foot & Ankle Surgery Podiatrist | E1-0000143 | DE | Yes |

## Other

- **Enumeration date:** 07/26/2006
- **Last updated:** 07/07/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 0001047917 | DELAWARE PHYSICIANS INC. | DE |
| 05 | — | 1000027213 | — | DE |
| 01 | — | 2245524000 | AMERIHEALTH/ KEYSTONE \# | DE |
| 01 | — | 7752539 | AETNA GROUP \# | DE |