Organization
SOUTHEASTERN FOOT & ANKLE ASSOCIATES, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT MCCONEKEY DPM (OWNER)
(910) 763-7578
Entity
Organization
Contact information
Practice address
920 S 17TH ST, WILMINGTON, NC 28401-8022
(910) 763-7578
(910) 763-9320
Mailing address
920 S 17TH ST, WILMINGTON, NC 28401-8022
(910) 763-7578
(910) 763-9320
Taxonomy
Speciality
Code
Description
License number
State
261QP1100X
Podiatric Clinic/Center
Primary
465
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2332798
MEDICARE PTAN
NC
05
—
890808U
—
NC
Enumeration date
03/05/2007
Last updated
08/30/2013
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