MEDICARE: MANHATTAN FOOT SPECIALISTS, PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	213ES0131X	Foot Surgery Podiatrist	12-00325	KS

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	114104	OTHER	KS	BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1114920303
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MANHATTAN FOOT SPECIALISTS, PA

Provider Business Mailing Address
First Line	:	915 WESTPORT PL
Second Line	:
City	:	MANHATTAN
State	:	KS
Zip	:	66502
Country	:	US
Telephone Number	:	785-539-4205
Fax Number	:	785-539-4204

Provider Business Practice Location Address
First Line	:	915 WESTPORT PL
Second Line	:
City	:	MANHATTAN
State	:	KS
Zip	:	66502
Country	:	US
Telephone Number	:	785-539-4205
Fax Number	:	785-539-4204

Authorized Official
Title or Position	:	PRESIDENT/DOCTOR
Name	:	DR. MICHAEL Q TRAN
Credential	:	DPM
Telephone Number	:	785-539-4205

Provider Enumeration Date	:	05/23/2005
Last Update Date	:	03/08/2021

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