Organization
ADVANCED FOOT & ANKLE CARE OF MEMPHIS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NATHAN LUCAS DPM (PRESIDENT)
(901) 309-8898
Entity
Organization
Contact information
Practice address
2900 KIRBY RD, SUITE 5, MEMPHIS, TN 38119-8221
(901) 309-8898
(901) 309-5908
Mailing address
2900 KIRBY RD, SUITE 5, MEMPHIS, TN 38119-8221
(901) 309-8898
(901) 309-5908
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
—
—
261QM1300X
Multi-Specialty Clinic/Center
—
—
261QP2000X
Physical Therapy Clinic/Center
—
—
261QP3300X
Pain Clinic/Center
—
—
293D00000X
Physiological Laboratory
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0002X
Clinic Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4259570001
DMERC
TN
Enumeration date
05/30/2007
Last updated
04/09/2020
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