MEDICARE: THIRD COAST FOOT AND ANKLE SC

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	213ES0131X	Foot Surgery Podiatrist

General Provider Information

NPI Number	:	1518592302
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THIRD COAST FOOT AND ANKLE SC

Provider Business Mailing Address
First Line	:	3333 S SUNNY SLOPE RD STE 102
Second Line	:
City	:	NEW BERLIN
State	:	WI
Zip	:	53151-4504
Country	:	US
Telephone Number	:	262-821-1588
Fax Number	:	262-821-6644

Provider Business Practice Location Address
First Line	:	3333 S SUNNY SLOPE RD STE 102
Second Line	:
City	:	NEW BERLIN
State	:	WI
Zip	:	53151-4504
Country	:	US
Telephone Number	:	262-821-1588
Fax Number	:	262-821-6644

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. LUCINDA R MEIER
Credential	:	DPM
Telephone Number	:	262-821-1588

Provider Enumeration Date	:	03/11/2020
Last Update Date	:	07/01/2025

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