Provider Demographics
NPI:1518034966
Name:COUNTY PODIATRIST INC
Entity Type:Organization
Organization Name:COUNTY PODIATRIST INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:A
Authorized Official - Last Name:FIGURA
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:314-894-3761
Mailing Address - Street 1:4105 UNION RD
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63129-1064
Mailing Address - Country:US
Mailing Address - Phone:314-894-3761
Mailing Address - Fax:
Practice Address - Street 1:4105 UNION RD
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63129-1064
Practice Address - Country:US
Practice Address - Phone:314-894-3761
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-29
Last Update Date:2012-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO000368213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO503895807Medicaid
MO503895807Medicaid
MOT42807Medicare UPIN
MO=========OtherEIN