NPI 1063630291

Ambulatory Foot Center PC

Organisation Foot & Ankle Surgery Podiatrist Grants Pass, OR

Practice location

Address: 1619 NW Hawthorne Ave STE 110, Grants Pass, OR 97526-6008
Phone: (541) 471-7056

Authorised official

Name: Mark L Simchuk
Title: Excutive Officer
Phone: (541) 471-7056

Registered specialties

Foot & Ankle Surgery Podiatrist Primary

Podiatric Medicine & Surgery Service Providers Taxonomy 213ES0103X Licence DP00291 (OR)

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Registry record

NPI: 1063630291
Entity type: Organization
NPI issued: 23 Apr 2007
Record last updated: 29 Oct 2025

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.