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Organization
MYPAFOOTDOCTOR
Active
Organization
MYPAFOOTDOCTOR
Active
Other names
South Penn Foot, Ankle and Wound Care Specialists
Organization subpart
No
Provider details
NPI number
Authorized official
JIM MAXKA DPM (SOLE OWNER)
(717) 524-1034
Entity
Organization
Contact information
Practice address
1055 BALTIMORE ST STE 1, HANOVER, PA 17331-4400
(717) 524-1034
(833) 524-1034
Mailing address
1055 BALTIMORE ST STE 1, HANOVER, PA 17331-4400
(717) 524-1034
(833) 524-1034
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
SC006213
PA
261QP1100X
Podiatric Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
103298961
—
PA
Enumeration date
04/28/2016
Last updated
04/30/2023
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