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Contact Information

MISSOURI DELTA FOOT AND ANKLE CENTERS, INC
522 VIRGINIA ST
SIKESTON, MO63801-5812
 Phone: 573-472-2202
 Fax: 573-472-3720
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Podiatrist

213E00000X 48 Podiatry
 

Durable Medical Equipment & Medical Supplies

332B00000X 54 Other Medical Supply Company
Indicates primary specialty

NPI Profile & details for MISSOURI DELTA FOOT AND ANKLE CENTERS, INC

NPI Number 1346389749
LBN Legal business name MISSOURI DELTA FOOT AND ANKLE CENTERS, INC
Authorized official HUGH PROTZEL - (OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 02/05/2007
Last updated 01/26/2012 - About 14 years ago
Identifiers
MO License # 000625
MO Medicaid 507579407
MO Medicaid 626035208
MO Other 9890 BLUE CROSS BLUE SHIELD MO
MO Other 55749 GHP
MO Other 176040 HEALTHLINK
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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