Provider Demographics
NPI:1003032723
Name:ANSERT FOOT & ANKLE CENTER P.S.C.
Entity Type:Organization
Organization Name:ANSERT FOOT & ANKLE CENTER P.S.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:R
Authorized Official - Last Name:ANSERT
Authorized Official - Suffix:JR
Authorized Official - Credentials:DPM
Authorized Official - Phone:812-949-1002
Mailing Address - Street 1:2315 GREEN VALLEY RD
Mailing Address - Street 2:STE 200
Mailing Address - City:NEW ALBANY
Mailing Address - State:IN
Mailing Address - Zip Code:47150-4649
Mailing Address - Country:US
Mailing Address - Phone:812-949-1002
Mailing Address - Fax:812-949-1007
Practice Address - Street 1:2315 GREEN VALLEY RD
Practice Address - Street 2:STE 200
Practice Address - City:NEW ALBANY
Practice Address - State:IN
Practice Address - Zip Code:47150-4649
Practice Address - Country:US
Practice Address - Phone:812-949-1002
Practice Address - Fax:812-949-1007
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-18
Last Update Date:2008-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY1081815Medicaid
KY7819Medicare PIN
IN1258920001Medicare NSC
IN230740Medicare PIN
KY1081815Medicaid