Healthcare Provider Details

I. General information

NPI: 1730356189
Provider Name (Legal Business Name): FOOT SURGICAL CENTER, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/14/2008
Last Update Date: 05/14/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3217 S CAROLYN AVE
SIOUX FALLS SD
57106-0744
US

IV. Provider business mailing address

3217 S CAROLYN AVE
SIOUX FALLS SD
57106-0744
US

V. Phone/Fax

Practice location:
  • Phone: 605-362-7997
  • Fax: 605-362-7930
Mailing address:
  • Phone: 605-362-7997
  • Fax: 605-362-7930

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number162
License Number StateSD

VIII. Authorized Official

Name: DR. ROBERT JOSEPH HEATH
Title or Position: PRESIDENT
Credential: DPM
Phone: 605-362-7997