Organization
COMMUNITY FOOT CLINIC OF MCPHERSON LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TRENT J TIMSON DPM (PODIATRIST)
(620) 241-3313
Entity
Organization
Contact information
Practice address
316 W 4TH ST, MCPHERSON, KS 67460-2301
(620) 241-3313
(620) 241-6967
Mailing address
316 W 4TH ST, MCPHERSON, KS 67460-2301
(620) 241-3313
(620) 241-6967
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
12-00301
KS
335E00000X
Prosthetic/Orthotic Supplier
12-00301
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100317700A
—
KS
Enumeration date
08/26/2013
Last updated
08/26/2013
Update your record
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