# FAYETTEVILLE FOOT AND ANKLE CENTER

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

## Provider details

- **NPI number:** 1821132424
- **Authorized official:** DR. GEORGE JOHN DEMETRI JR. D.P.M. (DOCTOR)
- **Authorized official phone:** (910) 483-3338

## Contact information

- **Practice address:** 503 OWEN DR, FAYETTEVILLE, NC 28304-3433
- **Practice address phone:** (910) 483-3338
- **Practice address fax:** (910) 483-3386
- **Mailing address:** 503 OWEN DR, FAYETTEVILLE, NC 28304-3433
- **Mailing address phone:** (910) 483-3338
- **Mailing address fax:** (910) 483-3386

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 213ES0103X | Foot & Ankle Surgery Podiatrist | 240 | NC | Yes |

## Other

- **Enumeration date:** 02/16/2007
- **Last updated:** 03/22/2011

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 0153T | BLUE CROSS BLUE SHIELD | NC |
| 05 | — | 890805F | — | NC |