Organization
SOUTHWEST MO FOOT CLINICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MATTHEW B RICHINS DPM (PRESIDENT)
(417) 782-7500
Entity
Organization
Contact information
Practice address
2024 S MAIDEN LN STE 201, JOPLIN, MO 64804-0319
(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
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
2006009605
MO
332BC3200X
Customized Equipment (DME)
2006009605
MO
335E00000X
Prosthetic/Orthotic Supplier
2006009605
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000015173
MEDICARE GROUP MO
MO
01
—
114142
KANSAS MEDICARE PROVIDER
KS
01
—
114206
KANSAS MEDICARE GROUP
KS
05
—
20422090B
—
KS
01
—
212522
BCBS MO
MO
05
—
301595708
—
MO
05
—
504920901
—
MO
05
—
626280200
—
MO
01
—
DG0016
RAILROAD MEDICARE GROUP
MO
01
—
P00408461
RAILROAD MEDICARE PROVIDE
MO
Enumeration date
08/29/2007
Last updated
09/12/2018
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