Healthcare Provider Details

I. General information

NPI: 1316097041
Provider Name (Legal Business Name): INDIANA REGIONAL FOOT & ANKLE CENTER PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/12/2007
Last Update Date: 02/06/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8060 MADISON AVE STE A
INDIANAPOLIS IN
46227-6002
US

IV. Provider business mailing address

8060 MADISON AVE STE A
INDIANAPOLIS IN
46227-6002
US

V. Phone/Fax

Practice location:
  • Phone: 317-882-0256
  • Fax: 317-882-0258
Mailing address:
  • Phone: 317-882-0256
  • Fax: 317-882-0258

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number07000908A
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number07000908A
License Number StateIN

VIII. Authorized Official

Name: PAUL FRANKLIN CAIN
Title or Position: OWNER/PHYSICIAN
Credential: DPM
Phone: 317-882-0256