Organization
INDIAN RIVER FOOT & ANKLE, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID J HAILE DPM (OWNER)
(772) 589-3110
Entity
Organization
Contact information
Practice address
1424 US HIGHWAY 1, SUITE A, SEBASTIAN, FL 32958-1619
(772) 589-3110
(772) 388-1929
Mailing address
1424 US HIGHWAY 1, SUITE A, SEBASTIAN, FL 32958-1619
(772) 589-3110
(772) 388-1929
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
390266800
—
FL
Enumeration date
10/16/2006
Last updated
04/01/2008
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