Provider Demographics
NPI:1396039996
Name:INDIANA CENTER FOR FOOT AND ANKLE CARE, PC
Entity Type:Organization
Organization Name:INDIANA CENTER FOR FOOT AND ANKLE CARE, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, PODIATRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ZIA
Authorized Official - Middle Name:
Authorized Official - Last Name:BARKATULLAH
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:601-826-7460
Mailing Address - Street 1:9465 COUNSELORS ROW
Mailing Address - Street 2:SUITE 200
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46240-6423
Mailing Address - Country:US
Mailing Address - Phone:800-578-4043
Mailing Address - Fax:888-524-7464
Practice Address - Street 1:9465 COUNSELORS ROW
Practice Address - Street 2:SUITE 200
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46240-6423
Practice Address - Country:US
Practice Address - Phone:800-578-4043
Practice Address - Fax:888-524-7464
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-01
Last Update Date:2011-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN07000992A213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN1558345975OtherNOT SURE, A PREVIOUS JOB OBTAINED THIS FOR ME