NPI 1295486116 · live from the CMS NPI Registry
Ellsworth Foot And Ankle
Podiatrist in Park City, UT. National Provider Identifier 1295486116, active.
NPI record
| NPI | 1295486116 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Podiatrist 213E00000X |
| Practice location | 1678 Bonanza Dr, Park City, UT 84060 |
| Practice phone | 801-253-6886 |
| Mailing address | 9980 S 300 W Ste 310, Sandy, UT 84070 |
| Enumerated | January 12, 2022 |
| Last updated | January 12, 2022 |
| Authorized official | Allison Peck, Credentialing Specialist |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Podiatrist primary | 213E00000X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.