Organization
THE FOOT DOCTORS, P.C.
Active
Organization
THE FOOT DOCTORS, P.C.
Active
Parent organization
THE FOOT DOCTORS, P.C.
Organization subpart
Yes
Provider details
NPI number
Legal business name
THE FOOT DOCTORS, P.C.
Authorized official
RUSSELL DIRKSEN DPM (OWNER)
(417) 883-1881
Entity
Organization
Contact information
Practice address
1015 HIGHWAY 248, BRANSON, MO 65616-8001
(417) 883-1881
(417) 883-4844
Mailing address
929 E MONTCLAIR ST, SUITE 100, SPRINGFIELD, MO 65807-5068
(417) 883-1881
(417) 883-4844
Taxonomy
Speciality
Code
Description
License number
State
213ES0131X
Foot Surgery Podiatrist
Primary
—
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
990001420
MEDICARE
MO
Enumeration date
09/02/2009
Last updated
09/02/2009
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