Provider Demographics
NPI:1235119983
Name:STERLING FOOT & ANKLE CTR PC
Entity Type:Organization
Organization Name:STERLING FOOT & ANKLE CTR PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DARRIN
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:DALLEGGE
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:970-522-7000
Mailing Address - Street 1:1127 CEDAR RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-1916
Mailing Address - Country:US
Mailing Address - Phone:970-571-2547
Mailing Address - Fax:
Practice Address - Street 1:101 PARK ST
Practice Address - Street 2:
Practice Address - City:STERLING
Practice Address - State:CO
Practice Address - Zip Code:80751-4134
Practice Address - Country:US
Practice Address - Phone:970-571-2547
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:STERLING FOOT & ANKLE CTR PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-01-19
Last Update Date:2011-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CODG7548Medicare PIN
CO1256080001Medicare NSC
COC50683Medicare PIN