Individual provider · Type 1 NPI

Jordan Zane Tacktill, DPM

Foot & Ankle Surgery Podiatrist · Roanoke, VA

NPI number 1942560727 Active

Practice location

222 Walnut Ave SW
Roanoke, VA 24016-4723

Specialties and licenses

TaxonomyCodeLicense
Foot & Ankle Surgery Podiatrist 213ES0103XPO3534 (FL)
Foot & Ankle Surgery Podiatrist Primary 213ES0103X0103301083 (VA)

Foot & Ankle Surgery Podiatrist: Definition to come...

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About NPI 1942560727

Jordan Zane Tacktill, DPM's National Provider Identifier is 1942560727, issued on May 25, 2012. The primary taxonomy on file is Foot & Ankle Surgery Podiatrist (213ES0103X), and the practice location is in Roanoke, VA. The record was last updated on Jan 10, 2022.