Organization
CARBON FOOT AND ANKLE CENTERS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KURT JOSEPH GUSTAFSON DPM (VICE PRESIDENT)
(610) 377-5544
Entity
Organization
Contact information
Practice address
215 S 1ST ST, LEHIGHTON, PA 18235-2163
(610) 377-5544
(610) 377-6744
Mailing address
215 S 1ST ST, LEHIGHTON, PA 18235-2163
(610) 377-5544
(610) 377-6744
Taxonomy
Speciality
Code
Description
License number
State
213ES0131X
Foot Surgery Podiatrist
Primary
SC004598L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1022344500001
—
PA
Enumeration date
08/19/2008
Last updated
02/05/2024
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