Muskogee Foot Clinic Inc.

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

Legal business name

MUSKOGEE FOOT CLINIC INC.

Practice address

2400 W Broadway St
Muskogee, OK 74401-2763

Phone

(918) 687-5171

Fax

(918) 687-7150

NPI assigned

Aug 23, 2007

Organization subpart

No

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

Authorized official

Name

Dr. David Lacy Green, D.P.M.

Title

Podiatrist

Phone

(918) 687-5171

Specialties & licenses 1

Addresses

Other names 1

• Muskogee Foot Clinic inc. Former legal business name

Locations

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

{
    "created_epoch": "1187827200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1276819200000",
    "number": "1568655488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2400 W BROADWAY ST",
            "city": "MUSKOGEE",
            "state": "OK",
            "postal_code": "744012763",
            "telephone_number": "918-687-5171",
            "fax_number": "918-687-7150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 W BROADWAY ST",
            "city": "MUSKOGEE",
            "state": "OK",
            "postal_code": "744012763",
            "telephone_number": "918-687-5171",
            "fax_number": "918-687-7150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MUSKOGEE FOOT CLINIC INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-23",
        "last_updated": "2010-06-18",
        "status": "A",
        "authorized_official_last_name": "GREEN",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "LACY",
        "authorized_official_title_or_position": "PODIATRIST",
        "authorized_official_telephone_number": "918-687-5171",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.P.M."
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Muskogee Foot Clinic inc.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Muskogee Dialysis LLC
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• Muskogee Family Practice
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• Muskogee Heart Center, Inc.
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• Muskogee Medical & Surgical Associates LLC
• Muskogee Medical and Surgical Associates, LLC

• Foot & Ankle Surgery Podiatrist in Muskogee, OK
• Providers in Muskogee, OK by specialty
• Foot & Ankle Surgery Podiatrist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2010; 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.