Organization
ADVANCED FOOT AND ANKLE CLINICS PA
Active
Other names
Advanced foot and ankle clinics
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STEPHEN SAMUEL PIROTTA DPM (PODIATRIST)
(479) 271-5353
Entity
Organization
Contact information
Practice address
903 SE 22ND ST, STE 1, BENTONVILLE, AR 72712-4196
(479) 271-5353
(479) 254-0698
Mailing address
903 SE 22ND ST, STE 1, BENTONVILLE, AR 72712-4196
(479) 271-5353
(479) 254-0698
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
133
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
129007717
MEDICAID
AR
05
—
129008748
—
AR
01
—
480033075
RR MCR
AR
Enumeration date
03/30/2007
Last updated
01/17/2013
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