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General NPI Number Information
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NPI Number | 1821460676
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Entity Type | Organization
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Legal Business Name | A STEP AHEAD FOOT AND ANKLE CLINIC
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Dates
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Enumeration Date | 10/20/2015
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Last Update Date | 08/24/2021
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Provider Practice Location Address
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Address Line | 2375 WHITE DR
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City | BATESVILLE
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State | AR
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Zip | 72501-9473
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Country | US
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Telephone | 870-345-3180
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Fax | 870-345-3180
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Provider Business Mailing Address
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Address Line | 2375 WHITE DR
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City | BATESVILLE
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State | AR
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Zip | 72501-9473
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Country | US
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Telephone | 870-345-3180
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Fax | 870-345-3180
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Authorized Official
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Title or Position | OWNER
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Name | DR. CALVIN D BAIZE
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Credential | DPM
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Telephone | 870-834-5249
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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 | 264
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License Number State | AR
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