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Organization

KHUMALO FOOT AND ANKLE CLINIC, INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
LISA KAY PAGE (CREDENTIALING MANAGER)
(731) 693-3465
Entity
Organization

Contact information

Practice address
1109 E REELFOOT AVE STE K, UNION CITY, TN 38261-5867
(731) 599-9909
(731) 599-9970
Mailing address
1109 E REELFOOT AVE STE K, UNION CITY, TN 38261-5867
(731) 599-9909
(731) 599-9970

Taxonomy

Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3352636
TN
05
7100242870
KY
05
7100815670
KY
05
Q051676
TN
Enumeration date
08/25/2019
Last updated
03/30/2026
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