Organization · Type 2 NPI
Ambulatory Foot Center PC
Foot & Ankle Surgery Podiatrist · Grants Pass, OR
NPI number
1063630291
Active
Practice location
1619 NW Hawthorne Ave Ste 110
Grants Pass, OR 97526-6008
Mailing address
1619 NW Hawthorne Ave, Ste 110
Grants Pass, OR 97526-6008
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Foot & Ankle Surgery Podiatrist Primary | 213ES0103X | DP00291 (OR) |
Foot & Ankle Surgery Podiatrist: Definition to come...
Another provider at this address
About NPI 1063630291
Ambulatory Foot Center PC's National Provider Identifier is 1063630291, issued on Apr 23, 2007. The primary taxonomy on file is Foot & Ankle Surgery Podiatrist (213ES0103X), and the practice location is in Grants Pass, OR. The record was last updated on Oct 29, 2025.