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Organization
NEO FOOT AND ANKLE INC
Active
Organization
NEO FOOT AND ANKLE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MATTHEW H ROBERTS D.P.M. (OWNER)
(918) 540-7655
Entity
Organization
Contact information
Practice address
310 2ND AVE SW, STE 102, MIAMI, OK 74354-6708
(918) 540-7655
(918) 540-7668
Mailing address
PO BOX 1323, MIAMI, OK 74355-1323
(918) 540-7655
(918) 540-7668
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
223
OK
332B00000X
Durable Medical Equipment & Medical Supplies
223
OK
363L00000X
Nurse Practitioner
0058567
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200049560A
—
OK
Enumeration date
07/18/2006
Last updated
02/16/2012
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