# EBERHARDT FOOT & ANKLE CLINIC

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

## Provider details

- **NPI number:** 1942371919
- **Authorized official:** DR. KEVIN NEAL EBERHARDT D.P.M. (PRESIDENT & CEO)
- **Authorized official phone:** (919) 776-0300

## Contact information

- **Practice address:** 111 DENNIS DR STE 123, SANFORD, NC 27330-6461
- **Practice address phone:** (919) 776-0300
- **Practice address fax:** (919) 776-0511
- **Mailing address:** 111 DENNIS DR STE 123, SANFORD, NC 27330-6461
- **Mailing address phone:** (919) 776-0300
- **Mailing address fax:** (919) 776-0511

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 213ES0103X | Foot & Ankle Surgery Podiatrist | 332 | NC | — |
| 213ES0103X | Foot & Ankle Surgery Podiatrist | — | NULL | Yes |
| 213ES0103X | Foot & Ankle Surgery Podiatrist | — | — | Yes |

## Other

- **Enumeration date:** 11/13/2006
- **Last updated:** 06/02/2015

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 0297L | BC/BS NC | NC |
| 01 | — | 2336170 | MEDICARE LEGACY NUMBER | — |
| 05 | — | 890297L | — | NC |
| 05 | — | 890806K | — | NC |