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SOUTHSIDE FOOT CLINIC P C NPI 1528117553


NPI Information

NPI: 1528117553
Provider Name: SOUTHSIDE FOOT CLINIC P C
Classification: Podiatrist - 213E00000X
Entity Type: Organization
Address:
33 E COUNTY LINE RD STE B
GREENWOOD, IN
ZIP 46143
Phone: (317) 882-9303
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SOUTHSIDE FOOT CLINIC P C is a podiatrist in Greenwood, IN. The provider is a podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical and other operative procedures, prescribe corrective devices and prescribe and administer drugs and physical therapy. SOUTHSIDE FOOT CLINIC P C NPI is 1528117553. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

33 E COUNTY LINE RD STE B
GREENWOOD, IN
ZIP 46143-043
Phone: (317) 882-9303
Fax: (317) 882-6605

The provider's authorized official is J Karl Winckelbach .
The authorized official title is Podiatrist and has the following contact phone number (317) 882-9303.

The enumeration date for this NPI number is 1/9/2007 and was last updated on 2/4/2008.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1213ES0103XPodiatristFoot & Ankle Surgery07000316INDIANANo
2332B00000XDurable Medical Equipment & Medical SuppliesNo
3213E00000XPodiatrist07000316INDIANAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
14691620001MEDICARE NSCINDIANA
2265340MEDICARE PININDIANA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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