Healthcare Provider Details
I. General information
NPI: 1699797910
Provider Name (Legal Business Name): STEPHEN JAMES FERRO DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 07/24/2006
Last Update Date: 07/15/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2200 SW GAGE BLVD T-M112
TOPEKA KS
66622-0001
US
IV. Provider business mailing address
3921 SW CHELMSFORD RD
TOPEKA KS
66610-1446
US
V. Phone/Fax
- Phone: 785-350-3111
- Fax: 785-350-4518
- Phone: 785-478-4445
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 213E00000X |
| Taxonomy | Podiatrist |
| License Number | 12-00203 |
| License Number State | KS |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 213ES0131X |
| Taxonomy | Foot Surgery Podiatrist |
| License Number | 12-00203 |
| License Number State | KS |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: