MEDICARE: HIGHLANDS FOOT AND ANKLE CLINIC

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	213ES0103X	Foot & Ankle Surgery Podiatrist	584	CO

General Provider Information

NPI Number	:	1174794622
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HIGHLANDS FOOT AND ANKLE CLINIC

Provider Business Mailing Address
First Line	:	PO BOX 632133
Second Line	:
City	:	LITTLETON
State	:	CO
Zip	:	80163-2133
Country	:	US
Telephone Number	:	303-346-3399
Fax Number	:

Provider Business Practice Location Address
First Line	:	9331 S COLORADO BLVD
Second Line	:	STE. #150
City	:	HIGHLANDS RANCH
State	:	CO
Zip	:	80126-7467
Country	:	US
Telephone Number	:	303-346-3399
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	JONATHON E SCOTT
Credential	:	DPM
Telephone Number	:	303-346-3399

Provider Enumeration Date	:	03/12/2008
Last Update Date	:	05/14/2008

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