Organization
ELLSWORTH FOOT AND ANKLE CLINIC
Active
Parent organization
ELLSWORTH FOOT AND ANKLE CLINIC
Other names
Summit Foot and Ankle
Organization subpart
Yes
Provider details
NPI number
Legal business name
ELLSWORTH FOOT AND ANKLE CLINIC
Authorized official
RYAN ELLSWORTH DPM (CEO)
(801) 253-6886
Entity
Organization
Contact information
Practice address
505 FAIRBURN RD SW STE 100, ATLANTA, GA 30331-2012
(404) 618-6077
(801) 253-6888
Mailing address
9980 S 300 W STE 300, SANDY, UT 84070-3654
(801) 253-6886
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
—
—
213EP1101X
Primary Podiatric Medicine Podiatrist
—
—
213ER0200X
Radiology Podiatrist
—
—
213ES0000X
Sports Medicine Podiatrist
—
—
213ES0131X
Foot Surgery Podiatrist
—
—
261QP1100X
Podiatric Clinic/Center
Primary
—
—
Other
Enumeration date
01/23/2021
Last updated
09/25/2024
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