ADVANCED FOOT & ANKLE OF WISCONSIN LLC NPI 1679608392

NPI Information

NPI: 1679608392
Provider Name: ADVANCED FOOT & ANKLE OF WISCONSIN LLC
Classification: Clinic/Center - 261QM1300X
Entity Type: Organization

Specialization: Multi-Specialty

Address:
1050 S MILWAUKEE AVENUE
STE 102
BURLINGTON, WI
ZIP 53105
Phone: (262) 763-9007
Get Directions

ADVANCED FOOT & ANKLE OF WISCONSIN LLC is a multi-specialty clinic center in Burlington, WI. ADVANCED FOOT & ANKLE OF WISCONSIN LLC NPI is 1679608392. The provider is registered as an organization entity type.

The provider's business location address is:

1050 S MILWAUKEE AVENUE
STE 102
BURLINGTON, WI
ZIP 53105-310
Phone: (262) 763-9007
Fax: (262) 758-6134

The provider's authorized official is Michael Edward Kokat .
The authorized official title is Ceo and has the following contact phone number (262) 763-9007.

The enumeration date for this NPI number is 2/22/2007 and was last updated on 1/21/2022.

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	261QM1300X	Clinic/Center	Multi-Specialty			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	43268700	MEDICAID	WISCONSIN

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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