Provider Demographics
NPI:1477594265
Name:CORINTH PODIATRY GROUP INC
Entity Type:Organization
Organization Name:CORINTH PODIATRY GROUP INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:CHRISTOPHER
Authorized Official - Last Name:COX
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:913-491-3311
Mailing Address - Street 1:3704 W 121ST ST
Mailing Address - Street 2:
Mailing Address - City:LEAWOOD
Mailing Address - State:KS
Mailing Address - Zip Code:66209-1070
Mailing Address - Country:US
Mailing Address - Phone:913-491-3311
Mailing Address - Fax:913-491-2801
Practice Address - Street 1:11111 NALL AVE
Practice Address - Street 2:SUITE 208
Practice Address - City:LEAWOOD
Practice Address - State:KS
Practice Address - Zip Code:66211-1620
Practice Address - Country:US
Practice Address - Phone:913-491-1244
Practice Address - Fax:913-491-2801
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-10
Last Update Date:2013-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DD7982OtherRR MEDICARE
DD7982OtherRR MEDICARE
0256860004Medicare NSC
4260000CMedicare PIN
4260000AMedicare PIN