Provider Demographics
NPI:1508186776
Name:THE FOOT CENTER PLC
Entity Type:Organization
Organization Name:THE FOOT CENTER PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:T
Authorized Official - Last Name:NEWMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:515-223-6214
Mailing Address - Street 1:2700 UNIVERSITY AVE
Mailing Address - Street 2:STE 212
Mailing Address - City:WEST DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50266-1451
Mailing Address - Country:US
Mailing Address - Phone:515-223-6214
Mailing Address - Fax:515-440-3776
Practice Address - Street 1:2700 UNIVERSITY AVE
Practice Address - Street 2:STE 212
Practice Address - City:WEST DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50266-1451
Practice Address - Country:US
Practice Address - Phone:515-223-6214
Practice Address - Fax:515-440-3776
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-10
Last Update Date:2010-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA00532213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
44779OtherBCBS
IA2081513Medicaid
44779OtherBCBS