Organization
QUEEN CITY FOOT AND ANKLE SPECIALISTS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROXANNE BURGESS D.P.M. (OWNER)
(704) 504-1004
Entity
Organization
Contact information
Practice address
11030 S TRYON ST, SUITE 308, CHARLOTTE, NC 28273-6530
(704) 504-1004
(704) 504-0007
Mailing address
11030 S TRYON ST, SUITE 308, CHARLOTTE, NC 28273-6530
(704) 504-1004
(704) 504-0007
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
461
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
89081AV
—
NC
Enumeration date
01/24/2006
Last updated
09/30/2011
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