Healthcare Provider Details

I. General information

NPI: 1841520137
Provider Name (Legal Business Name): FOOT CARE INDY, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/08/2010
Last Update Date: 12/30/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5202 N KEYSTONE AVE
INDIANAPOLIS IN
46220-3602
US

IV. Provider business mailing address

2727 E 55TH ST #20210
INDIANAPOLIS IN
46220-3658
US

V. Phone/Fax

Practice location:
  • Phone: 317-255-3668
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XX0004X
TaxonomyOrthopaedic Foot and Ankle Surgery Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: JEFF SCHABLER
Title or Position: PRESIDENT
Credential:
Phone: 317-255-3668