MEDICARE: BUNION SURGERY SPECIALISTS 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	213ES0103X	Foot & Ankle Surgery Podiatrist

General Provider Information

NPI Number	:	1124883327
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BUNION SURGERY SPECIALISTS LLC

Provider Business Mailing Address
First Line	:	3 N 17TH ST
Second Line	:
City	:	FORT DODGE
State	:	IA
Zip	:	50501-4211
Country	:	US
Telephone Number	:	515-639-3775
Fax Number	:	833-598-2060

Provider Business Practice Location Address
First Line	:	3 N 17TH ST
Second Line	:
City	:	FORT DODGE
State	:	IA
Zip	:	50501-4211
Country	:	US
Telephone Number	:	515-639-3775
Fax Number	:	833-598-2060

Authorized Official
Title or Position	:	OWNER
Name	:	MINDI JO DAYTON
Credential	:	DPM
Telephone Number	:	515-639-2775

Provider Enumeration Date	:	02/16/2024
Last Update Date	:	02/16/2024

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