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GLENN F DEVRIES NPI 1265510564


NPI Information

NPI: 1265510564
Provider Name: GLENN F DEVRIES

Doing Business As: RIPON FOOT CLINIC

Classification: Podiatrist - 213ES0103X
Entity Type: Organization

Specialization: Foot & Ankle Surgery

Address:
680 E FOND DU LAC ST
RIPON, WI
ZIP 54971
Phone: (920) 748-3009
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GLENN F DEVRIES is a foot and ankle surgery podiatrist in Ripon, WI. GLENN F DEVRIES NPI is 1265510564. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Ripon Foot Clinic.

The provider's business location address is:

680 E FOND DU LAC ST
RIPON, WI
ZIP 54971-500
Phone: (920) 748-3009
Fax: (920) 748-3109

The provider's authorized official is Glenn F Devries .
The authorized official title is Owner and has the following contact phone number (920) 748-3009.

The enumeration date for this NPI number is 11/2/2006 and was last updated on 8/17/2009.


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 Surgery467WISCONSINYes

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
10691500001MEDICARE NSCWISCONSIN
285630MEDICARE ID-TYPE UNSPECIFIEDWISCONSIN

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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