Provider Type Icon

FAMILY FOOT CLINIC SC NPI 1063515526


NPI Information

NPI: 1063515526
Provider Name: FAMILY FOOT CLINIC, SC
Classification: Podiatrist - 213E00000X
Entity Type: Organization
Address:
21 S MARR ST
FOND DU LAC, WI
ZIP 54935
Phone: (920) 921-1669
Get Directions

FAMILY FOOT CLINIC, SC is a podiatrist in Fond Du Lac, WI. 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. FAMILY FOOT CLINIC, SC NPI is 1063515526. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

21 S MARR ST
FOND DU LAC, WI
ZIP 54935-334
Phone: (920) 921-1669
Fax: (920) 921-7950

The provider's authorized official is Ian Charles Furness .
The authorized official title is President and has the following contact phone number (920) 921-1669.

The enumeration date for this NPI number is 9/7/2006 and was last updated on 5/21/2010.


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
1213E00000XPodiatristWISCONSINYes

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
1000085810MEDICARE PIN
2=========016OTHERWISCONSINANTHEM BLUE CROSSBLUE SHI
343264100MEDICAIDWISCONSIN
4CQ2458OTHERWISCONSINRR/MEDICARE
50393560002MEDICARE NSCWISCONSIN
60393560001MEDICARE NSCWISCONSIN

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

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.