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General NPI Number Information
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NPI Number | 1841482940
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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 | 08/13/2007
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Last Update Date | 08/13/2020
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Provider Practice Location Address
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Address Line | 11725 N ILLINOIS ST STE 560
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City | CARMEL
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State | IN
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Zip | 46032-3009
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Country | US
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Telephone | 317-346-7722
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Fax | 317-346-7725
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Provider Business Mailing Address
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Address Line | 1876 NORTHWOOD PLAZA DR BOX 351
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City | FRANKLIN
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State | IN
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Zip | 46131-2702
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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 | PODIATRIST
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Name | DR. 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 | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | 07000710
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License Number State | IN
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