Provider Demographics
NPI:1003597709
Name:MERRELL FOOT & ANKLE PLLC
Entity Type:Organization
Organization Name:MERRELL FOOT & ANKLE PLLC
Other - Org Name:A STEP AHEAD FOOT & ANKLE CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICIAN-PODIATRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:KALE
Authorized Official - Middle Name:JO
Authorized Official - Last Name:MERRELL
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:605-210-2562
Mailing Address - Street 1:1410 NORTH AVE STE 1
Mailing Address - Street 2:
Mailing Address - City:SPEARFISH
Mailing Address - State:SD
Mailing Address - Zip Code:57783-1574
Mailing Address - Country:US
Mailing Address - Phone:605-722-3668
Mailing Address - Fax:605-722-3669
Practice Address - Street 1:1410 NORTH AVE STE 1
Practice Address - Street 2:
Practice Address - City:SPEARFISH
Practice Address - State:SD
Practice Address - Zip Code:57783-1574
Practice Address - Country:US
Practice Address - Phone:605-722-3668
Practice Address - Fax:605-722-3669
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-26
Last Update Date:2023-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP1100XAmbulatory Health Care FacilitiesClinic/CenterPodiatric