Healthcare Provider Details
I. General information
NPI: 1760329726
Provider Name (Legal Business Name): FOOT SPECIALISTS OF KANSAS CITY, PA
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/29/2026
Last Update Date: 04/29/2026
Certification Date: 04/29/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3600 NE RALPH POWELL RD STE D
LEES SUMMIT MO
64064-2369
US
IV. Provider business mailing address
PO BOX 825159
PHILADELPHIA PA
19182-5159
US
V. Phone/Fax
- Phone: 816-943-1111
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 213E00000X |
| Taxonomy | Podiatrist |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 213ES0103X |
| Taxonomy | Foot & Ankle Surgery Podiatrist |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 332B00000X |
| Taxonomy | Durable Medical Equipment & Medical Supplies |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
DANIEL
JOSEPH
THOUVENOT
Title or Position: PARTNER
Credential:
Phone: 618-236-7444