Jeffrey B Pupp
Organization Active NPI Foot & Ankle Surgery Podiatrist · Wallace, NC
NPI 1275709677 · NPPES record last updated May 6, 2008
Key facts
- NPI
- 1275709677
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Foot & Ankle Surgery Podiatrist 213ES0103X
- License
- 449 (NC)
- Legal business name
- JEFFREY B PUPP
- Practice address
- 114 N Norwood St
Wallace, NC 28466-2730 - Phone
- (910) 285-3362
- Fax
- (910) 285-6683
- NPI assigned
- May 6, 2008
- Organization subpart
- No
Authorized official
- Name
- Dr. Jeffrey B Pupp
- Title
- Owner
- Phone
- (910) 285-3362
Practitioners 2
-
Kevin Gregory Bachman, D.P.M.
-
Jeffrey Bruce Pupp, D.P.M.
National Provider Directory
Locations
928 N Norwood St
Wallace, NC 28466
Phone (910) 285-3362
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Foot & Ankle Surgery Podiatrist |
213ES0103X | 449 | NC | Yes |
| Foot Surgery Podiatrist |
213ES0131X | 230 | NC |
Addresses
Primary practice location
114 N Norwood St
Wallace, NC 28466-2730
Mailing address
114 N Norwood St
Wallace, NC 28466-2730
Phone (910) 285-3362
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 890152P | Medicaid | NC | |
| 2432650A | Other | NC | MEDICARE PTAN |
| CJ7762 | Other | NC | RAILROAD MEDICARE PTAN |
| 0152P | Other | NC | BCBS NC |
| B1114 | Other | NC | MEDCOST |
Other names
- Wallace Foot Center
Other providers in Wallace, NC
- Robyn Hursley
- Jemma Holley Imwalle
- Instride Foot and Ankle Specialists, PLLC
- Interim Healthcare of the Eastern Carolinas, Inc
- Michael James
- Johnson Blackburn
- Mary Anna Johnson
- Kelly Chiropractic Center of Wallace
- Kidzcare Pediatrics, PC
- Ashley B King
All providers in Wallace, NC · Foot & Ankle Surgery Podiatrist in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 6, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.