Healthcare Provider Details

I. General information

NPI: 1184528473
Provider Name (Legal Business Name): WEST MICHIGAN FOOT AND ANKLE PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/08/2026
Last Update Date: 10/08/2026
Certification Date: 10/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1710 US HIGHWAY 31 S
MANISTEE MI
49660-8931
US

IV. Provider business mailing address

333 N JEBAVY DR
LUDINGTON MI
49431-1923
US

V. Phone/Fax

Practice location:
  • Phone: 231-398-5080
  • Fax: 231-600-7077
Mailing address:
  • Phone: 231-843-2690
  • Fax: 231-600-7077

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number
License Number StateNULL

VIII. Authorized Official

Name: DR. ALEXUS SQUIRES
Title or Position: DOCTOR, OWNER OF PRACTICE
Credential: DPM
Phone: 231-843-2690