MEDICARE: LAWRENCE PODIATRY CENTER LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	213E00000X	Podiatrist	1200392	KS

General Provider Information

NPI Number	:	1013255207
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LAWRENCE PODIATRY CENTER LLC

Provider Business Mailing Address
First Line	:	4102 W 6TH ST STE A
Second Line	:
City	:	LAWRENCE
State	:	KS
Zip	:	66049-4626
Country	:	US
Telephone Number	:	785-843-0973
Fax Number	:	785-843-1839

Provider Business Practice Location Address
First Line	:	4102 W 6TH ST STE A
Second Line	:
City	:	LAWRENCE
State	:	KS
Zip	:	66049-4626
Country	:	US
Telephone Number	:	785-843-0973
Fax Number	:	785-843-1839

Authorized Official
Title or Position	:	OWNER
Name	:	CLEVE RICHARD PILAKOWSKI
Credential	:
Telephone Number	:	785-843-0973

Provider Enumeration Date	:	01/22/2013
Last Update Date	:	03/10/2026

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