Provider Demographics
NPI:1447097977
Name:PREMIER FOOT AND ANKLE RECONSTRUCTIVE SURGERY PLLC
Entity type:Organization
Organization Name:PREMIER FOOT AND ANKLE RECONSTRUCTIVE SURGERY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KIMBERLEE
Authorized Official - Middle Name:B
Authorized Official - Last Name:HOBIZAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:515-664-2827
Mailing Address - Street 1:2620 CONSTITUTION BLVD STE 104
Mailing Address - Street 2:
Mailing Address - City:BEAVER FALLS
Mailing Address - State:PA
Mailing Address - Zip Code:15010-1278
Mailing Address - Country:US
Mailing Address - Phone:412-830-7837
Mailing Address - Fax:412-909-4168
Practice Address - Street 1:2620 CONSTITUTION BLVD STE 104
Practice Address - Street 2:
Practice Address - City:BEAVER FALLS
Practice Address - State:PA
Practice Address - Zip Code:15010-1278
Practice Address - Country:US
Practice Address - Phone:412-830-7837
Practice Address - Fax:412-909-4168
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-11
Last Update Date:2024-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty