Provider Demographics
NPI:1508838939
Name:ANSERT, DONALD R JR (DPM)
Entity Type:Individual
Prefix:DR
First Name:DONALD
Middle Name:R
Last Name:ANSERT
Suffix:JR
Gender:M
Credentials:DPM
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Mailing Address - Street 1:2315 GREEN VALLEY RD
Mailing Address - Street 2:STE. 200
Mailing Address - City:NEW ALBANY
Mailing Address - State:IN
Mailing Address - Zip Code:47150-4649
Mailing Address - Country:US
Mailing Address - Phone:812-949-1002
Mailing Address - Fax:812-949-1007
Practice Address - Street 1:2315 GREEN VALLEY RD
Practice Address - Street 2:STE. 200
Practice Address - City:NEW ALBANY
Practice Address - State:IN
Practice Address - Zip Code:47150-4649
Practice Address - Country:US
Practice Address - Phone:812-949-1002
Practice Address - Fax:812-949-1007
Is Sole Proprietor?:No
Enumeration Date:2006-02-01
Last Update Date:2010-04-14
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
KY231213ES0103X
IN07000824A213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY1081815Medicaid
IN200186870AMedicaid
INU66659Medicare UPIN
IN230740BMedicare PIN
KY0781901Medicare PIN