Organization
JEFFERSON CITY FOOT & ANKLE CLINIC, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JONATHON W STRONG D.P.M. (OWNER)
(573) 638-2655
Entity
Organization
Contact information
Practice address
1705 CHRISTY DR, JEFFERSON CITY, MO 65101-5195
(573) 638-2655
(573) 634-3985
Mailing address
1705 CHRISTY DR, JEFFERSON CITY, MO 65101-5195
(573) 638-2655
(573) 634-3985
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
2002018117
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000014232
MEDICARE, PTAN
MO
05
—
504916909
—
MO
Enumeration date
10/19/2006
Last updated
08/28/2012
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