Provider Demographics
NPI:1518198696
Name:ANIMAS FOOT AND ANKLE
Entity Type:Organization
Organization Name:ANIMAS FOOT AND ANKLE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/PODIATRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:BEN
Authorized Official - Middle Name:STUART
Authorized Official - Last Name:WEHRLI
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:970-259-3154
Mailing Address - Street 1:975 RIVERGATE
Mailing Address - Street 2:UNIT 105
Mailing Address - City:DURANGO
Mailing Address - State:CO
Mailing Address - Zip Code:81301-7490
Mailing Address - Country:US
Mailing Address - Phone:970-259-3154
Mailing Address - Fax:970-259-9766
Practice Address - Street 1:975 RIVERGATE
Practice Address - Street 2:UNIT 105
Practice Address - City:DURANGO
Practice Address - State:CO
Practice Address - Zip Code:81301-7490
Practice Address - Country:US
Practice Address - Phone:970-259-3154
Practice Address - Fax:970-259-9766
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-06
Last Update Date:2011-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO690213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO690OtherSTATE LICENSE FOR PRESIDENT
1013151331OtherPRESIDENT NPI
1013151331OtherPRESIDENT NPI