Organization
ACHILLES FOOT & ANKLE SURGERY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRUCE GARY BLANK DPM (PRESIDENT)
(740) 633-4188
Entity
Organization
Contact information
Practice address
2108 LUMBER AVE STE 2, WHEELING, WV 26003-5350
(304) 243-8799
(740) 633-4716
Mailing address
2108 LUMBER AVE STE 2, WHEELING, WV 26003-5350
(304) 243-8799
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
00239
WV
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
36002569B
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0099535001
—
WV
05
—
01756671
—
PA
05
—
2006260
—
OH
01
—
5125771
AETNA
—
Enumeration date
12/28/2005
Last updated
04/20/2008
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