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Organization
ANDREW L MCCALL DPM PA
Active
Organization
ANDREW L MCCALL DPM PA
Active
Other names
Ankle and Foot Clinic of Idaho
Organization subpart
No
Provider details
NPI number
Authorized official
ANDREW L MCCALL DPM (OWNER)
(208) 529-0229
Entity
Organization
Contact information
Practice address
2920 CORTEZ AVE, IDAHO FALLS, ID 83404-7554
(208) 529-0229
(888) 688-3439
Mailing address
2920 CORTEZ AVE, IDAHO FALLS, ID 83404-7554
(208) 529-0229
(888) 688-3439
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010150955
REGENCE BLUE SHIELD OF ID
ID
01
—
1351211
MEDICARE INDIVIDUAL PTAN
ID
05
—
807308400
—
ID
01
—
P9335
BLUE CROSS OF IDAHO
ID
Enumeration date
04/10/2007
Last updated
09/19/2011
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