Organization
FOOT & ANKLE SPECIALTY CLINIC INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ALAYE ELDRED WHYTE DPM (PRESIDENT)
(318) 636-2669
Entity
Organization
Contact information
Practice address
1714 KINGS HWY, SHREVEPORT, LA 71103-4152
(318) 636-2669
(318) 636-2663
Mailing address
1714 KINGS HWY, SHREVEPORT, LA 71103-4152
(318) 636-2669
(318) 636-2663
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
PD166R
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1674541
—
LA
Enumeration date
09/13/2010
Last updated
09/13/2010
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