Organization
ANKLE AND FOOT CENTERS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STEVEN GARY TILLETT DPM (CEO)
(503) 246-2212
Entity
Organization
Contact information
Practice address
6274 SW CAPITOL HWY, PORTLAND, OR 97239-2674
(503) 246-2212
(503) 246-4050
Mailing address
6274 SW CAPITOL HWY, PORTLAND, OR 97239-2674
(503) 246-2212
(503) 246-4050
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
DP00300
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
227113
OMAP
OR
05
—
227113
—
OR
01
—
DG6557
RR MCR
—
Enumeration date
03/06/2007
Last updated
02/12/2020
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