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General NPI Number Information
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NPI Number | 1558338137
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Entity Type | Organization
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Legal Business Name | FOOT & ANKLE SPECIALISTS SC
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Dates
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Enumeration Date | 03/02/2006
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Last Update Date | 05/11/2010
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Provider Practice Location Address
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Address Line | 7423 W GREENFIELD AVE
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City | WEST ALLIS
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State | WI
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Zip | 53214-4614
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Country | US
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Telephone | 414-258-8945
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Fax | 414-258-7712
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Provider Business Mailing Address
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Address Line | 7423 W GREENFIELD AVE
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City | WEST ALLIS
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State | WI
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Zip | 53214-4614
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Country | US
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Telephone | 414-258-8945
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Fax | 414-258-7712
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Authorized Official
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Title or Position | OWNER
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Name | RANDY S. PAUERS
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Credential | D.P.M.
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Telephone | 414-258-8945
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number |
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License Number State |
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