Organization
FAMILY FOOT CARE ASSOC. P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KENT A VAN BELOIS (PRESIDENT)
(910) 483-8304
Entity
Organization
Contact information
Practice address
4286 RAEFORD RD, FAYETTEVILLE, NC 28304-3247
(910) 483-8304
Mailing address
4286 RAEFORD RD, FAYETTEVILLE, NC 28304-3247
(910) 483-8304
Taxonomy
Speciality
Code
Description
License number
State
261QP1100X
Podiatric Clinic/Center
Primary
92
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
08186
BLUE CROSS BLUE SHIELD
NC
01
—
243039
MEDICARE
NC
05
—
8908186
—
NC
Enumeration date
08/16/2010
Last updated
07/06/2012
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