Southfield Family Foot Center, P.C.

Primary specialty

PodiatristTaxonomy code 213E00000X

License

5901001176 Issued in MI

Legal business name

SOUTHFIELD FAMILY FOOT CENTER, P.C.

Practice address

17422 W 10 Mile Rd
Southfield, MI 48075-2951

Phone

(248) 557-2400

Fax

(248) 557-5533

NPI assigned

Mar 29, 2006

Last updated

May 23, 2008By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Lawrence B Richard, D.P.M.

Title

President

Phone

(248) 557-2400

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1143590400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1211500800000",
    "number": "1326009325",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17422 W 10 MILE RD",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480752951",
            "telephone_number": "248-557-2400",
            "fax_number": "248-557-5533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17422 W 10 MILE RD",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480752951",
            "telephone_number": "248-557-2400",
            "fax_number": "248-557-5533"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHFIELD FAMILY FOOT CENTER, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-29",
        "last_updated": "2008-05-23",
        "status": "A",
        "authorized_official_last_name": "RICHARD",
        "authorized_official_first_name": "LAWRENCE",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "248-557-2400",
        "authorized_official_credential": "D.P.M."
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "MI",
            "license": "5901001176",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM GROUP",
            "identifier": "480F302060",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Southfield Dental Center PC
• Southfield Dental PLLC
• Southfield Essential Care PLLC
• Southfield Family Dental Center
• Southfield Family Dental Center PLLC
• Southfield Family Physicians, PLLC
• Southfield Family Practice PLLC
• Southfield Gastroenterology Associates PC
• Southfield Gum Docs, LLC (Michigan Gum Docs)
• Southfield Internists PC

• Podiatrist in Southfield, MI
• Providers in Southfield, MI by specialty
• Podiatrist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.