Provider Demographics
NPI:1508951302
Name:FOOT CARE, INC.
Entity Type:Organization
Organization Name:FOOT CARE, INC.
Other - Org Name:ANN SEIFERT-WILSON DPM
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ANN
Authorized Official - Middle Name:M
Authorized Official - Last Name:SEIFERT-WILSON
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:636-456-3338
Mailing Address - Street 1:1428 N STATE HIGHWAY 47
Mailing Address - Street 2:SUITE D
Mailing Address - City:WARRENTON
Mailing Address - State:MO
Mailing Address - Zip Code:63383-1375
Mailing Address - Country:US
Mailing Address - Phone:636-456-3338
Mailing Address - Fax:636-456-3335
Practice Address - Street 1:1428 N STATE HIGHWAY 47
Practice Address - Street 2:SUITE D
Practice Address - City:WARRENTON
Practice Address - State:MO
Practice Address - Zip Code:63383-1375
Practice Address - Country:US
Practice Address - Phone:636-456-3338
Practice Address - Fax:636-456-3335
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-04
Last Update Date:2008-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO000549213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO367491909Medicaid
CF8846OtherRR MCR
CF8846OtherRR MCR
MO367491909Medicaid