Healthcare Provider Details

I. General information

NPI: 1174457980
Provider Name (Legal Business Name): DECKER FOOT & ANKLE PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/09/2026
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6785 MYERS LAKE AVE NE STE C
ROCKFORD MI
49341-7415
US

IV. Provider business mailing address

4310 LEONARD ST NW STE 103
WALKER MI
49534-8447
US

V. Phone/Fax

Practice location:
  • Phone: 616-874-8772
  • Fax: 616-874-7956
Mailing address:
  • Phone: 616-453-6329
  • Fax: 616-453-1725

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: JOSHUA R DECKER
Title or Position: PRESIDENT
Credential: DPM
Phone: 616-874-8772