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General NPI Number Information
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NPI Number | 1003903220
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Entity Type | Organization
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Legal Business Name | HOOSIER FOOT & ANKLE, LLC
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Dates
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Enumeration Date | 10/09/2006
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Last Update Date | 06/08/2009
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Provider Practice Location Address
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Address Line | 2545 FOX POINTE DR SUITE E
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City | COLUMBUS
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State | IN
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Zip | 47203-3220
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Country | US
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Telephone | 812-378-3668
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Fax | 812-378-5770
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Provider Business Mailing Address
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Address Line | 1876 NORTHWOOD PLAZA DRIVE BOX 351
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City | FRANKLIN
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State | IN
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Zip | 46131
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Country | US
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Telephone | 317-346-7722
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Fax | 317-346-7722
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Authorized Official
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Title or Position | OWNER/PHYSICIAN
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Name | PATRICK ALLEN DEHEER
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Credential | DPM
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Telephone | 317-346-7722
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number |
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License Number State |
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