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Organization

FOOT & ANKLE ASSOCIATES OF THE TRIAD, PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. THURMOND ERIC SICELOFF DPM (PRESIDENT)
(336) 774-4021
Entity
Organization

Contact information

Practice address
3641 WESTGATE CENTER CIR, SUITE A, WINSTON SALEM, NC 27103-2936
(336) 774-4021
(336) 774-4024
Mailing address
3641 WESTGATE CENTER CIR, SUITE A, WINSTON SALEM, NC 27103-2936
(336) 774-4021
(336) 774-4024

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
021WJ
BCBS
NC
05
5912100
NC
Enumeration date
07/02/2009
Last updated
01/07/2010
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