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BAY AREA FOOT CLINIC NPI 1659551083


NPI Information

NPI: 1659551083
Provider Name: BAY AREA FOOT CLINIC
Classification: Podiatrist - 213ES0103X
Entity Type: Organization

Specialization: Foot & Ankle Surgery

Address:
2295 W MASON ST
GREEN BAY, WI
ZIP 54303
Phone: (920) 498-2226
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BAY AREA FOOT CLINIC is a foot and ankle surgery podiatrist in Green Bay, WI. BAY AREA FOOT CLINIC NPI is 1659551083. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

2295 W MASON ST
GREEN BAY, WI
ZIP 54303-706
Phone: (920) 498-2226

The provider's authorized official is Thomas R Komp .
The authorized official title is Owner and has the following contact phone number (920) 498-2226.

The enumeration date for this NPI number is 11/14/2007 and was last updated on 7/17/2008.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1213ES0103XPodiatristFoot & Ankle SurgeryYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
141732500OTHERWISCONSINMEDICAID DME
20256660001MEDICARE NSCWISCONSIN
3000081004MEDICARE PINWISCONSIN

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: 4/28/2024

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