Organization
VALARIE IKERD DPM LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VALARIE IKERD DPM (OWNER)
(417) 659-9395
Entity
Organization
Contact information
Practice address
1501 E 20TH ST, JOPLIN, MO 64804-0928
(417) 659-9395
(417) 659-9695
Mailing address
1501 E 20TH ST, JOPLIN, MO 64804-0928
(417) 659-9395
(417) 659-9695
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
112612
BCBS
MO
05
—
1962652834
—
MO
Enumeration date
09/26/2008
Last updated
02/24/2015
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