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Contact Information

ACTIVE PODIATRY PC
1910 LAFAYETTE RD
CRAWFORDSVILLE, IN47933-1037
 Phone: 765-362-7200
 Fax: 765-362-4870
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Podiatrist

213E00000X 48 Podiatry
 

Surgery, Foot & Ankle

213ES0103X 48 Podiatry
Indicates primary specialty

NPI Profile & details for ACTIVE PODIATRY PC · (Female)

NPI Number 1730363748
Status Active
Credentials
Entity Individual
Enumeration date 12/27/2007
Last updated 05/01/2024 - About 2 years ago
Sole proprietor 1 Not specified
Identifiers
  • IN License # 07000857A
  • IN Medicaid 200178610
  • IN Other 000000480680 ANTHEM /BCBS
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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