Provider Demographics
NPI:1093837239
Name:COMPREHENSIVE FOOT & ANKLE, SC
Entity Type:Organization
Organization Name:COMPREHENSIVE FOOT & ANKLE, SC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CINDY
Authorized Official - Middle Name:G
Authorized Official - Last Name:SCHMID
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:715-634-9023
Mailing Address - Street 1:819 ASH ST
Mailing Address - Street 2:
Mailing Address - City:SPOONER
Mailing Address - State:WI
Mailing Address - Zip Code:54801-1201
Mailing Address - Country:US
Mailing Address - Phone:715-634-9023
Mailing Address - Fax:715-634-9935
Practice Address - Street 1:819 ASH ST
Practice Address - Street 2:
Practice Address - City:SPOONER
Practice Address - State:WI
Practice Address - Zip Code:54801-1201
Practice Address - Country:US
Practice Address - Phone:715-634-9023
Practice Address - Fax:715-634-9935
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-06
Last Update Date:2009-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI43269400Medicaid
WI000086425Medicare PIN
WI000086425Medicare ID - Type UnspecifiedMEDICARE NUMBER
WI43269400Medicaid