Provider Demographics
NPI:1053914481
Name:ANKLE & FOOT ASSOCIATES OF NORTHERN MICHIGAN PC
Entity type:Organization
Organization Name:ANKLE & FOOT ASSOCIATES OF NORTHERN MICHIGAN PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:M
Authorized Official - Last Name:BRAUSA
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:989-275-3668
Mailing Address - Street 1:PO BOX 949
Mailing Address - Street 2:
Mailing Address - City:ROSCOMMON
Mailing Address - State:MI
Mailing Address - Zip Code:48653-0949
Mailing Address - Country:US
Mailing Address - Phone:989-275-3668
Mailing Address - Fax:989-275-3338
Practice Address - Street 1:5213 W HOUGHTON LAKE DR
Practice Address - Street 2:
Practice Address - City:HOUGHTON LAKE
Practice Address - State:MI
Practice Address - Zip Code:48629-8214
Practice Address - Country:US
Practice Address - Phone:989-275-3668
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-18
Last Update Date:2024-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty