Organization
DOWNTOWN SKYWAY FOOT SPECIALISTS INC
Active
Organization
DOWNTOWN SKYWAY FOOT SPECIALISTS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WILLIAM BOLIN LOCKNER DPM (OWNER)
(612) 332-7720
Entity
Organization
Contact information
Practice address
825 NICOLLET MALL, SUITE 517 MEDICAL ARTS BLDG, MINNEAPOLIS, MN 55402-2606
(612) 332-7720
(612) 333-8981
Mailing address
825 NICOLLET MALL, SUITE 517 MEDICAL ARTS BLDG, MINNEAPOLIS, MN 55402-2606
(612) 332-7720
(612) 333-8981
Taxonomy
Speciality
Code
Description
License number
State
213ES0131X
Foot Surgery Podiatrist
Primary
359
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
062096300
—
MN
01
—
10074LO
BLUECROSSBLUESHIELD
MN
01
—
102943
HEALTHPARTNERS
MN
01
—
165613
UCARE
MN
01
—
2728357
MEDICA
MN
01
—
535942
AMERICA'S PPO
MN
01
—
768181046629
PREFERRED ONE
MN
01
—
DC5459
RAILROAD MEDICARE
MN
Enumeration date
11/08/2005
Last updated
08/10/2012
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