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Contact Information

BRIDGETON FOOT AND ANKLE LLC
12255 DE PAUL DR
STE. 470
BRIDGETON, MO63044-2510
 Phone: 314-739-8863
 Fax: 314-739-6448
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Podiatrist

213E00000X 48 Podiatry
Indicates primary specialty

NPI Profile & details for BRIDGETON FOOT AND ANKLE LLC · (Female)

NPI Number 1205975968
Status Active
Credentials
Entity Individual
Enumeration date 02/06/2007
Last updated 12/03/2009 - About 17 years ago
Sole proprietor 1 Not specified
Identifiers
  • MO License # 000551
  • MO Medicaid 300628401
  • MO Medicaid 303231500
  • MO Other 32B00000X MEDICAID DME
  • MO Other 504595802 MEDICAID GROUP
  • MO Other 310171750 MEDICARE CPIN
  • MO Other 480034196 RR MEDICARD
  • MO Other P00419552 RR MEDICARE
  • MO Other 2700030 UHC
  • MO Other 2784098 UHC
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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