Provider Demographics
NPI:1548576960
Name:RED EARTH FOOT AND ANKLE INC.
Entity Type:Organization
Organization Name:RED EARTH FOOT AND ANKLE INC.
Other - Org Name:OKLAHOMA FOOT AND ANKLE INSTITUTE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PODIATRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:NICK
Authorized Official - Middle Name:B
Authorized Official - Last Name:PLANTS
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:405-370-3457
Mailing Address - Street 1:13316 SOUTH WESTERN, SUITE I
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73170
Mailing Address - Country:US
Mailing Address - Phone:405-307-7100
Mailing Address - Fax:405-307-1707
Practice Address - Street 1:13316 SOUTH WESTERN, SUITE I
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73170
Practice Address - Country:US
Practice Address - Phone:405-307-7100
Practice Address - Fax:405-307-7107
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-23
Last Update Date:2015-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK280213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK7307820001Medicare NSC