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Organization
EBERHARDT FOOT & ANKLE CLINIC
Active
Organization
EBERHARDT FOOT & ANKLE CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KEVIN NEAL EBERHARDT D.P.M. (PRESIDENT & CEO)
(919) 776-0300
Entity
Organization
Contact information
Practice address
111 DENNIS DR STE 123, SANFORD, NC 27330-6461
(919) 776-0300
(919) 776-0511
Mailing address
111 DENNIS DR STE 123, SANFORD, NC 27330-6461
(919) 776-0300
(919) 776-0511
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
332
NC
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
—
NULL
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0297L
BC/BS NC
NC
01
—
2336170
MEDICARE LEGACY NUMBER
—
05
—
890297L
—
NC
05
—
890806K
—
NC
Enumeration date
11/13/2006
Last updated
06/02/2015
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