Provider Demographics
NPI:1639277312
Name:FOOT ASSOCIATES PC
Entity Type:Organization
Organization Name:FOOT ASSOCIATES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:
Authorized Official - Last Name:BALLOW
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:303-758-9031
Mailing Address - Street 1:7090 E HAMPDEN AVE
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80224-3022
Mailing Address - Country:US
Mailing Address - Phone:303-758-9031
Mailing Address - Fax:303-758-7643
Practice Address - Street 1:7090 E HAMPDEN AVE
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80224-3022
Practice Address - Country:US
Practice Address - Phone:303-758-9031
Practice Address - Fax:303-758-7643
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2008-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO337213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO1114620001Medicare NSC
COT60235Medicare UPIN
COC11608Medicare PIN