Healthcare Provider Details

I. General information

NPI: 1255341236
Provider Name (Legal Business Name): WARREN W ABBOTT DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/09/2006
Last Update Date: 10/05/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5000 SW 21ST ST
TOPEKA KS
66604-4510
US

IV. Provider business mailing address

PO BOX 67143
TOPEKA KS
66667-0143
US

V. Phone/Fax

Practice location:
  • Phone: 785-273-3500
  • Fax: 785-273-3515
Mailing address:
  • Phone: 785-273-3500
  • Fax: 785-273-3515

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213EP1101X
TaxonomyPrimary Podiatric Medicine Podiatrist
License Number1200140
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: