MEDICARE: DR. LARRY WILLIAM PIPER DPM

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	000362	MO

General Provider Information

NPI Number	:	1801890678
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LARRY WILLIAM PIPER DPM

Provider Business Mailing Address
First Line	:	1005A W SAINT MAARTENS DR
Second Line	:
City	:	SAINT JOSEPH
State	:	MO
Zip	:	64506-2989
Country	:	US
Telephone Number	:	816-364-2338
Fax Number	:	816-364-1003

Provider Business Practice Location Address
First Line	:	1005A W SAINT MAARTENS DR
Second Line	:
City	:	SAINT JOSEPH
State	:	MO
Zip	:	64506-2989
Country	:	US
Telephone Number	:	816-364-2338
Fax Number	:	816-364-1003

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/09/2005
Last Update Date	:	07/08/2007

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