Provider Demographics
NPI:1598822728
Name:FOOT SPECIALISTS OF LAPEER, PLLC
Entity Type:Organization
Organization Name:FOOT SPECIALISTS OF LAPEER, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SINGLE MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:ERNEST
Authorized Official - Middle Name:W
Authorized Official - Last Name:LEFEVER
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:810-664-1250
Mailing Address - Street 1:1390 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:LAPEER
Mailing Address - State:MI
Mailing Address - Zip Code:48446-1349
Mailing Address - Country:US
Mailing Address - Phone:810-664-1250
Mailing Address - Fax:810-664-0315
Practice Address - Street 1:1390 N MAIN ST
Practice Address - Street 2:
Practice Address - City:LAPEER
Practice Address - State:MI
Practice Address - Zip Code:48446-1349
Practice Address - Country:US
Practice Address - Phone:810-664-1250
Practice Address - Fax:810-664-0315
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-03
Last Update Date:2008-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4313291Medicaid
MI0D410150OtherBLUE CARE NETWORK
MICH8473OtherRAILROAD MEDICARE
MI4313308Medicaid
MI0D410150OtherBLUE CROSS BLUE SHIELD OF
MI4409614Medicaid
MICH8473OtherRAILROAD MEDICARE
MI4155400001Medicare NSC