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Organization
MIDWEST FOOT & ANKLE SURGICAL CENTER
Active
Organization
MIDWEST FOOT & ANKLE SURGICAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEROME R RANDALL JR. DPM (MEMBER)
(866) 335-1091
Entity
Organization
Contact information
Practice address
3915 W CAPITOL DR, MILWAUKEE, WI 53216-2528
(866) 335-1091
(866) 335-1091
Mailing address
7940 FARMHOUSE RD, FRANKFORT, IL 60423-6810
(866) 335-1091
(866) 335-1091
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
NULL
Other
Enumeration date
11/21/2014
Last updated
11/21/2014
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