Provider Demographics
NPI:1689793291
Name:PODIATRY ASSOCIATES, INC
Entity Type:Organization
Organization Name:PODIATRY ASSOCIATES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:A
Authorized Official - Last Name:SVOBODA
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:785-539-7664
Mailing Address - Street 1:1133 COLLEGE AVE STE A215
Mailing Address - Street 2:
Mailing Address - City:MANHATTAN
Mailing Address - State:KS
Mailing Address - Zip Code:66502-2781
Mailing Address - Country:US
Mailing Address - Phone:785-539-7664
Mailing Address - Fax:785-539-3359
Practice Address - Street 1:1133 COLLEGE AVE STE A215
Practice Address - Street 2:
Practice Address - City:MANHATTAN
Practice Address - State:KS
Practice Address - Zip Code:66502-2781
Practice Address - Country:US
Practice Address - Phone:785-539-7664
Practice Address - Fax:785-539-3359
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1200163213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KST77060Medicare UPIN
KS015072Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER