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Organization
GASTON FOOT & ANKLE ASSOCIATES P A
Active
Organization
GASTON FOOT & ANKLE ASSOCIATES P A
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID RUSSELL KIRLIN DPM (PRESIDENT)
(704) 861-0425
Entity
Organization
Contact information
Practice address
251 WILMOT DR, GASTONIA, NC 28054-4048
(704) 861-0425
(704) 861-0274
Mailing address
251 WILMOT DR, GASTONIA, NC 28054-4048
(704) 861-0425
(704) 861-0274
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
060A
BCBS
NC
01
—
102463
WELLNES
—
01
—
13835
WELLPATH/COVENTRY
—
01
—
2058521
AETNA
—
05
—
8900160A
—
NC
05
—
PDN999
—
SC
Enumeration date
09/12/2005
Last updated
05/18/2010
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