Healthcare Provider Details
I. General information
NPI: 1801116652
Provider Name (Legal Business Name): LOOKING GLASS FOOT & ANKLE PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/03/2010
Last Update Date: 05/20/2026
Certification Date: 05/20/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
13765 S SEDONA PKWY
LANSING MI
48906-8103
US
IV. Provider business mailing address
13765 S SEDONA PKWY
LANSING MI
48906-8103
US
V. Phone/Fax
- Phone: 517-668-6166
- Fax: 517-668-6169
- Phone: 517-668-6166
- Fax: 517-668-6169
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 213ES0103X |
| Taxonomy | Foot & Ankle Surgery Podiatrist |
| License Number | 5901002235 |
| License Number State | MI |
VIII. Authorized Official
Name: DR.
ANDREA
KAY
SIMONS
Title or Position: OWNER
Credential: DPM
Phone: 517-668-6166