MEDICARE: AFFILIATED FOOT CARE CLINIC PC

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	335E00000X	Prosthetic/Orthotic Supplier
2	332B00000X	Durable Medical Equipment & Medical Supplies

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1831372812
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AFFILIATED FOOT CARE CLINIC PC

Provider Business Mailing Address
First Line	:	5120 CHARLESTOWN RD
Second Line	:	STE 6
City	:	NEW ALBANY
State	:	IN
Zip	:	47150-9497
Country	:	US
Telephone Number	:	812-944-5600
Fax Number	:	812-944-4674

Provider Business Practice Location Address
First Line	:	5120 CHARLESTOWN RD
Second Line	:	STE 6
City	:	NEW ALBANY
State	:	IN
Zip	:	47150-9497
Country	:	US
Telephone Number	:	812-944-5600
Fax Number	:	812-944-4674

Authorized Official
Title or Position	:	OWNER
Name	:	DR. STEVEN MOSLEY
Credential	:	D.P.M.
Telephone Number	:	812-944-5600

Provider Enumeration Date	:	12/12/2007
Last Update Date	:	02/12/2013

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Directions to “AFFILIATED FOOT CARE CLINIC PC ” Practice Location

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