Organization
NESHOBA FOOT AND ANKLE CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. STEPHANIE BUTLER (CBO MANAGER)
(601) 663-1423
Entity
Organization
Contact information
Practice address
1003 HOLLAND AVE, SUITE 102, PHILADELPHIA, MS 39350-2180
(601) 663-1423
(601) 663-1474
Mailing address
1003 HOLLAND AVE, SUITE 102, PHILADELPHIA, MS 39350-2180
(601) 663-1423
(601) 663-1474
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
80193
MS
Other
Enumeration date
05/19/2009
Last updated
05/19/2009
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