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General NPI Number Information
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NPI Number | 1629602073
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Entity Type | Organization
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Legal Business Name | ESSENTIAL FOOT AND ANKLE
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Dates
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Enumeration Date | 02/25/2020
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Last Update Date | 02/25/2020
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Provider Practice Location Address
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Address Line | 15520 S DOWNING ST
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City | OLATHE
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State | KS
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Zip | 66062-6306
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Country | US
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Telephone | 913-839-3443
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Fax |
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Provider Business Mailing Address
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Address Line | 15520 S DOWNING ST
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City | OLATHE
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State | KS
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Zip | 66062-6306
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Country | US
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Telephone | 913-839-3443
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Fax |
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Authorized Official
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Title or Position | PODIATRIST
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Name | THOMAS CHAD HEWITT
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Credential | DPM
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Telephone | 816-914-3905
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0131X
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Taxonomy Name | Foot Surgery Podiatrist
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License Number |
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License Number State |
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