Organization
MYPAFOOTDOCTOR
Active
Other names
South Penn Foot, Ankle and Wound Care Specialists
Organization subpart
No
Provider details
NPI number
Authorized official
JIM MAXKA DPM (SOLE OWNER)
(717) 524-1034
Entity
Organization
Contact information
Practice address
1055 BALTIMORE ST STE 1, HANOVER, PA 17331-4400
(717) 524-1034
(833) 524-1034
Mailing address
1055 BALTIMORE ST STE 1, HANOVER, PA 17331-4400
(717) 524-1034
(833) 524-1034
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
SC006213
PA
261QP1100X
Podiatric Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
103298961
—
PA
Enumeration date
04/28/2016
Last updated
04/30/2023
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