Organization
COMMONWEALTH FOOT & ANKLE SPECIALISTS LLC
Active
Other names
Commonwealth Foot & Ankle Specialists
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JUSTIN A PHILLINGANE DPM (FOOT & ANKLE SPECIALIST)
(804) 365-5898
Entity
Organization
Contact information
Practice address
2552 ALDRIDGE AVE, SOUTH CHESTERFIELD, VA 23834-5306
(804) 365-5898
Mailing address
4704 BARREL POINT RD, PRINCE GEORGE, VA 23875-2976
(305) 206-7638
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
0103301225
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0103301225
VIRGINIA BOARD OF MEDICINE
VA
Enumeration date
07/24/2018
Last updated
07/24/2018
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