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Organization

SOUTHWEST FOOT & ANKLE SPECIALISTS, PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. TAMARA M WHITAKER BAY DPM (OWNER)
(269) 385-1000
Entity
Organization

Contact information

Practice address
515 HOWARD ST, KALAMAZOO, MI 49008-1917
(269) 385-1000
(269) 385-5120
Mailing address
515 HOWARD ST, KALAMAZOO, MI 49008-1917
(269) 385-1000
(269) 385-5120

Taxonomy

Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
TW002034
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
480C912300
BCBS
MI
05
4841159
MI
Enumeration date
05/12/2006
Last updated
09/09/2008
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