Provider Demographics
NPI:1114971173
Name:PRECISION FOOT & ANKLE CENTER PC
Entity Type:Organization
Organization Name:PRECISION FOOT & ANKLE CENTER PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DPM PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:E
Authorized Official - Last Name:SLUITER
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:402-926-2600
Mailing Address - Street 1:7811 CHICAGO COURT
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68114
Mailing Address - Country:US
Mailing Address - Phone:402-926-2600
Mailing Address - Fax:402-926-2605
Practice Address - Street 1:7811 CHICAGO COURT
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68114
Practice Address - Country:US
Practice Address - Phone:402-926-2600
Practice Address - Fax:402-926-2605
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-22
Last Update Date:2007-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE291213E00000X
NE292213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10025113300Medicaid
NE5130280001Medicare NSC
NE10025113300Medicaid