WHITE BEAR FOOT AND ANKLE CLINIC INC. NPI 1659777290

NPI Information

NPI: 1659777290
Provider Name: WHITE BEAR FOOT AND ANKLE CLINIC, INC.
Classification: Clinic/Center - 261QP1100X
Entity Type: Organization

Specialization: Podiatric

Address:
4653 WHITE BEAR PKWY
WHITE BEAR LAKE, MN
ZIP 55110
Phone: (651) 426-3995
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WHITE BEAR FOOT AND ANKLE CLINIC, INC. is a podiatric clinic center in White Bear Lake, MN. WHITE BEAR FOOT AND ANKLE CLINIC, INC. NPI is 1659777290. The provider is registered as an organization entity type.

The provider's business location address is:

4653 WHITE BEAR PKWY
WHITE BEAR LAKE, MN
ZIP 55110-300
Phone: (651) 426-3995
Fax: (651) 426-5626

The provider's authorized official is Christopher Phillips .
The authorized official title is Doctor/owner and has the following contact phone number (651) 426-3995.

The enumeration date for this NPI number is 11/10/2014 and was last updated on 11/10/2014.

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
1	261QP1100X	Clinic/Center	Podiatric	923	MINNESOTA	Yes

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
1	472603200	MEDICAID	MINNESOTA

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

NPI Synchronization or Removal

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