# KHUMALO FOOT AND ANKLE CLINIC, INC

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

## Provider details

- **NPI number:** 1366099269
- **Authorized official:** LISA KAY PAGE (CREDENTIALING MANAGER)
- **Authorized official phone:** (731) 693-3465

## Contact information

- **Practice address:** 1109 E REELFOOT AVE STE K, UNION CITY, TN 38261-5867
- **Practice address phone:** (731) 599-9909
- **Practice address fax:** (731) 599-9970
- **Mailing address:** 1109 E REELFOOT AVE STE K, UNION CITY, TN 38261-5867
- **Mailing address phone:** (731) 599-9909
- **Mailing address fax:** (731) 599-9970

## Taxonomy

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

## Other

- **Enumeration date:** 08/25/2019
- **Last updated:** 03/30/2026