Organization
DOMINION FOOT AND ANKLE CENTER,LTD.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GEORGE KENNETH MARINO DPM (PRESIDENT)
(804) 378-1818
Entity
Organization
Contact information
Practice address
13305A MIDLOTHIAN TPKE, MIDLOTHIAN, VA 23113-4211
(804) 378-1818
(804) 378-1818
Mailing address
PO BOX 561, MIDLOTHIAN, VA 23113-0561
(804) 378-1818
(804) 794-3827
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
0103000786
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
480011660
RAILROAD MEDICARE PIN
VA
05
—
9332014
—
VA
Enumeration date
04/25/2008
Last updated
04/25/2008
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