Organization
FOOT GROUP INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WAYNE STEVEN DAVIS DPM (OWNER)
(865) 966-5775
Entity
Organization
Contact information
Practice address
10918 KINGSTON PIKE, KNOXVILLE, TN 37934-2931
(865) 966-5775
(865) 966-5743
Mailing address
PO BOX 22429, KNOXVILLE, TN 37933-0429
(865) 966-5775
(865) 966-5743
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
DPM170
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2008661
BLUE SHIELD
TN
05
—
3350711
—
TN
Enumeration date
02/26/2008
Last updated
04/02/2015
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