Organization
SOUTHWEST MISSOURI FOOT CLINICS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MATTHEW B RICHINS DPM (PRESIDENT)
(417) 782-7500
Entity
Organization
Contact information
Practice address
2630 CUNNINGHAM AVE, JOPLIN, MO 64804-1542
(417) 782-7500
(417) 782-7524
Mailing address
PO BOX 3592, JOPLIN, MO 64803-3592
(417) 782-7500
(417) 782-7524
Taxonomy
Speciality
Code
Description
License number
State
261QP1100X
Podiatric Clinic/Center
Primary
2006009605
MO
332B00000X
Durable Medical Equipment & Medical Supplies
2006009605
MO
332BC3200X
Customized Equipment (DME)
2006009605
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000015173
MO MEDICARE GROUP
MO
01
—
114206
KS MEDICARE GROUP
KS
01
—
212522
BCBS MO
MO
05
—
504920901
—
MO
01
—
DG0016
RAILROAD MEDICARE
MO
Enumeration date
10/02/2006
Last updated
06/25/2021
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