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Organization
COASTAL CAROLINA FOOT & ANKLE ASSOCIATES PA
Active
Organization
COASTAL CAROLINA FOOT & ANKLE ASSOCIATES PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KATHY N WALKER (PRACTICE ADMINISTRATOR)
(910) 343-8889
Entity
Organization
Contact information
Practice address
1602 DOCTORS CIR, WILMINGTON, NC 28401-7406
(910) 343-8889
(910) 343-9990
Mailing address
1602 DOCTORS CIR, WILMINGTON, NC 28401-7406
(910) 343-8889
(910) 343-9990
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
230
NC
213ES0103X
Foot & Ankle Surgery Podiatrist
449
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0231R
BCBS NC
NC
01
—
2347992
MEDICARE PTAN
NC
05
—
890231R
—
NC
01
—
B1115
MEDCOST
NC
01
—
DR7169
RAILROAD MEDICARE PTAN
NC
Enumeration date
05/09/2006
Last updated
09/17/2013
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