# WILDE FOOT & ANKLE CLINIC PA

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Southeast Kansas Foot Clinic PA
- **Organization subpart:** No

## Provider details

- **NPI number:** 1225253305
- **Authorized official:** DR. CORIN Q WILDE DPM (OWNER)
- **Authorized official phone:** (620) 231-5940

## Contact information

- **Practice address:** 407 E CENTENNIAL DR, PITTSBURG, KS 66762-6505
- **Practice address phone:** (620) 231-5940
- **Practice address fax:** (620) 231-5948
- **Mailing address:** 407 E CENTENNIAL DR, PITTSBURG, KS 66762-6505
- **Mailing address phone:** (620) 231-5940
- **Mailing address fax:** (620) 231-5948

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 213ES0103X | Foot & Ankle Surgery Podiatrist | 1200315 | KS | Yes |

## Other

- **Enumeration date:** 04/16/2007
- **Last updated:** 05/04/2011