Organization
CENTER GROVE FOOT & ANKLE CARE, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK H. RUNKLE D.P.M. (PRESIDENT)
(317) 859-2905
Entity
Organization
Contact information
Practice address
7855 S EMERSON AVE STE T, INDIANAPOLIS, IN 46237-8669
(317) 859-2905
Mailing address
7855 S EMERSON AVE STE T, INDIANAPOLIS, IN 46237-8669
(317) 859-2905
Taxonomy
Speciality
Code
Description
License number
State
261QP1100X
Podiatric Clinic/Center
Primary
07000797
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200035220
—
IN
01
—
480033210
RAILROAD MEDICARE
IN
Enumeration date
11/09/2007
Last updated
02/26/2025
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