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Organization

MISSOURI DELTA FOOT AND ANKLE CENTERS, INC

Active
Other names
Foot and Ankle Centers of Southeast Missouri
Organization subpart
No

Provider details

NPI number
Authorized official
DR. HUGH RAYMOND PROTZEL DPM (OWNER)
(573) 472-2202
Entity
Organization

Contact information

Practice address
522 VIRGINIA ST, SIKESTON, MO 63801-5812
(573) 472-2202
(573) 472-3720
Mailing address
522 VIRGINIA ST, SIKESTON, MO 63801-5812
(573) 472-2202
(573) 472-3720

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
332B00000X
Durable Medical Equipment & Medical Supplies
000625
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
176040
HEALTHLINK
MO
05
507579407
MO
01
55749
GHP
MO
05
626035208
MO
01
9890
BLUE CROSS BLUE SHIELD MO
MO
Enumeration date
02/05/2007
Last updated
01/26/2012
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