# ADVANCED ANKLE AND FOOT CENTER, LLC

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

## Provider details

- **NPI number:** 1760556104
- **Authorized official:** ROBERT B VANCOURT DPM (OWNER PODIATRIST)
- **Authorized official phone:** (614) 792-3668

## Contact information

- **Practice address:** 9759 FAIRWAY DR, POWELL, OH 43065
- **Practice address phone:** (614) 792-3668
- **Practice address fax:** (614) 792-7615
- **Mailing address:** PO BOX 1554, REYNOLDSBURG, OH 43068-6554
- **Mailing address phone:** (614) 792-3668
- **Mailing address fax:** (614) 792-7615

## Taxonomy

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

## Other

- **Enumeration date:** 11/18/2006
- **Last updated:** 08/29/2012

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | DE8613 | RAILROAD MEDICARE | — |