Organization
MID-WEST PODIATRY AND ASSOCIATES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SANDY PIKE (ADMINISTRATOR)
(314) 432-5683
Entity
Organization
Contact information
Practice address
851 E 5TH ST, SUITE 320, WASHINGTON, MO 63090-3135
(636) 239-1633
(636) 390-8633
Mailing address
851 E 5TH ST, SUITE 320, WASHINGTON, MO 63090-3135
(636) 239-1633
(636) 390-8633
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
365905405
—
MO
05
—
365905413
—
MO
Enumeration date
12/22/2006
Last updated
09/14/2017
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