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ADVANCED FOOT AND ANKLE CLINICS PA NPI 1114047438


NPI Information

NPI: 1114047438
Provider Name: ADVANCED FOOT AND ANKLE CLINICS PA

Former Legal Business Name: ADVANCED FOOT AND ANKLE CLINICS

Classification: Podiatrist - 213E00000X
Entity Type: Organization
Address:
903 SE 22ND ST
STE 1
BENTONVILLE, AR
ZIP 72712
Phone: (479) 271-5353
Get Directions

ADVANCED FOOT AND ANKLE CLINICS PA is a podiatrist in Bentonville, AR. 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. ADVANCED FOOT AND ANKLE CLINICS PA NPI is 1114047438. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Former Legal Business Name Is Advanced Foot And Ankle Clinics.

The provider's business location address is:

903 SE 22ND ST
STE 1
BENTONVILLE, AR
ZIP 72712-196
Phone: (479) 271-5353
Fax: (479) 254-0698

The provider's authorized official is Stephen Samuel Pirotta .
The authorized official title is Podiatrist and has the following contact phone number (479) 271-5353.

The enumeration date for this NPI number is 3/30/2007 and was last updated on 1/17/2013.


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
1213E00000XPodiatrist133ARKANSASYes

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
1129008748MEDICAIDARKANSAS
24297280002MEDICARE NSC
3480033075OTHERARKANSASRR MCR
4U32668MEDICARE UPIN
5129007717OTHERARKANSASMEDICAID
65G120MEDICARE PIN

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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