MEDICARE: MISSOURI FOOT AND ANKLE CLINICS, P.C.

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	000774	MO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	4349950001	OTHER	DMERC
2	CJ9038	OTHER	RR MCR
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1255435897
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MISSOURI FOOT AND ANKLE CLINICS, P.C.

Provider Business Mailing Address
First Line	:	256 SW WINTERPARK CIR
Second Line	:
City	:	LEES SUMMIT
State	:	MO
Zip	:	64081-4013
Country	:	US
Telephone Number	:	816-224-8660
Fax Number	:	816-200-9005

Provider Business Practice Location Address
First Line	:	1136 W 40 HWY
Second Line	:
City	:	BLUE SPRINGS
State	:	MO
Zip	:	64015-4610
Country	:	US
Telephone Number	:	816-224-8660
Fax Number	:	816-200-9005

Authorized Official
Title or Position	:	OWNER
Name	:	DR. DANIEL RAYMOND HANON
Credential	:	DPM
Telephone Number	:	816-224-8660

Provider Enumeration Date	:	09/12/2006
Last Update Date	:	06/25/2010

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