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Organization
SOUTHSIDE FOOT CLINIC P C
Active
Organization
SOUTHSIDE FOOT CLINIC P C
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. J KARL WINCKELBACH DPM (PODIATRIST)
(317) 882-9303
Entity
Organization
Contact information
Practice address
33 E COUNTY LINE RD STE B, GREENWOOD, IN 46143-1043
(317) 882-9303
(317) 882-6605
Mailing address
33 E COUNTY LINE RD STE B, GREENWOOD, IN 46143-1043
(317) 882-9303
(317) 882-6605
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
07000316
IN
213ES0103X
Foot & Ankle Surgery Podiatrist
07000316
IN
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
Other
Enumeration date
01/09/2007
Last updated
02/04/2008
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