Organization
ACTIVE PODIATRY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. YONG S. CHAE D.P.M. (PRESIDENT/OWNER)
(765) 362-7200
Entity
Organization
Contact information
Practice address
1910 LAFAYETTE RD, CRAWFORDSVILLE, IN 47933-1037
(765) 362-7200
(765) 362-4870
Mailing address
1910 LAFAYETTE RD, CRAWFORDSVILLE, IN 47933-1037
(765) 362-7200
(765) 362-4870
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
07000857A
IN
213ES0103X
Foot & Ankle Surgery Podiatrist
07000857A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000480680
ANTHEM /BCBS
IN
05
—
200178610
—
IN
Enumeration date
12/27/2007
Last updated
05/01/2024
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