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NPI Code Detail

MEDICARE: IDEAL FOOT AND ANKLE CARE, PLLC

MEDICARE: IDEAL FOOT AND ANKLE CARE, PLLC
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
1213EP1101XPrimary Podiatric Medicine Podiatrist5901002332MI
2213ES0103XFoot & Ankle Surgery Podiatrist5901002332MI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
113565770436OTHERMINPI

General Provider Information

NPI Number : 1689075939
Entity Type Code : Organization
Provider Name (Legal Business Name) : IDEAL FOOT AND ANKLE CARE, PLLC
Provider Business Mailing Address
First Line : 1044 W ROWLAND ST
Second Line :
City : GRAND BLANC
State : MI
Zip : 48507-4047
Country : US
Telephone Number : 419-704-6846
Fax Number :
Provider Business Practice Location Address
First Line : 1044 W ROWLAND ST
Second Line :
City : GRAND BLANC
State : MI
Zip : 48507-4047
Country : US
Telephone Number : 419-704-6846
Fax Number :
Authorized Official
Title or Position : OWNER/OPERATOR
Name : DR. SARAH POPE
Credential : DPM
Telephone Number : 419-704-6846
Provider Enumeration Date : 09/05/2014
Last Update Date : 09/19/2022

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Directions to “IDEAL FOOT AND ANKLE CARE, PLLC ” Practice Location

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