Foot and Ankle Specialists of Western Missouri LLC
Organization Active NPI Podiatrist · Higginsville, MO
NPI 1992985097 · NPPES record last updated May 22, 2008
Key facts
- NPI
- 1992985097
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Podiatrist 213E00000X
- License
- 000672 (MO)
- Legal business name
- FOOT AND ANKLE SPECIALISTS OF WESTERN MISSOURI LLC
- Practice address
- 12 W 19TH St
Higginsville, MO 64037-1507 - Phone
- (660) 584-2927
- Fax
- (660) 584-7444
- NPI assigned
- Nov 6, 2007
- Organization subpart
- Yes
- Parent organization (as reported)
- FOOT AND ANKLE SPECIALISTS OF WESTERN MISSOURI LLC
Authorized official
- Name
- Dr. Rick Dean Grayson, DPM
- Title
- Owner
- Phone
- (660) 584-2927
National Provider Directory
- Part of
- Foot and Ankle Specialists of Western Missouri LLC
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Podiatrist |
213E00000X | 000672 | MO | Yes |
Addresses
Primary practice location
12 W 19TH St
Higginsville, MO 64037-1507
Mailing address
12 W 19TH St
Higginsville, MO 64037-1507
Phone (660) 584-2927
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 307862904 | Medicaid | MO |
Other providers in Higginsville, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 22, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.