Healthcare Provider Details

I. General information

NPI: 1700848348
Provider Name (Legal Business Name): ROBERT SCOTT FOSTER DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/06/2006
Last Update Date: 03/16/2020
Certification Date: 03/16/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

305 N KEENE ST SUITE 209
COLUMBIA MO
65201-6897
US

IV. Provider business mailing address

305 N KEENE ST SUITE 209
COLUMBIA MO
65201-6897
US

V. Phone/Fax

Practice location:
  • Phone: 573-443-2015
  • Fax: 573-449-5886
Mailing address:
  • Phone: 573-443-2015
  • Fax: 573-449-5886

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code213EP0504X
TaxonomyPublic Medicine Podiatrist
License Number000539
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code213EP1101X
TaxonomyPrimary Podiatric Medicine Podiatrist
License Number000539
License Number StateMO
# 3
Primary TaxonomyN
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number000539
License Number StateMO
# 4
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number000539
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: