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NPI Code Detail

MEDICARE: STEPHEN M OFFUTT DPM

MEDICARE: STEPHEN M OFFUTT DPM
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
1213ES0103XFoot & Ankle Surgery Podiatrist0700991AIN

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1P01287668OTHERINRAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
207000991AOTHERINSTATE LICENSE
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
411267445OTHERINCAQH
5MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1700889102
Entity Type Code : Individual
Provider Name (Legal Business Name) : STEPHEN M OFFUTT DPM
Provider Business Mailing Address
First Line : 8780 PURDUE RD
Second Line : SUITE # 7
City : INDIANAPOLIS
State : IN
Zip : 46268-6129
Country : US
Telephone Number : 317-471-8701
Fax Number : 317-471-8702
Provider Business Practice Location Address
First Line : 8780 PURDUE RD
Second Line : SUITE # 7
City : INDIANAPOLIS
State : IN
Zip : 46268-6129
Country : US
Telephone Number : 317-471-8701
Fax Number : 317-471-8702
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/31/2005
Last Update Date : 03/07/2023

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Practice Location Address:
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Practice Fax: 317-471-8702
1831136878 — DR. THOMAS WILLIAM ALLEY M.D.
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1770667396 — RICHARD PASSEY MD
Practice Location Address:
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1811030885 — DR. MARILYN J DARGIS M.D.
Practice Location Address:
8780 PURDUE RD , SUITE # 7
INDIANAPOLIS, IN
46268-6129
Practice Phone: 317-471-8701
Practice Fax: 317-471-8702

Directions to “ STEPHEN M OFFUTT DPM” Practice Location

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