Provider Demographics
NPI:1699859306
Name:HAMILTON FOOT & ANKLE CARE, LLC
Entity Type:Organization
Organization Name:HAMILTON FOOT & ANKLE CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:VOGEL
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:317-284-8888
Mailing Address - Street 1:9865 E 116TH ST
Mailing Address - Street 2:SUITE 300
Mailing Address - City:FISHERS
Mailing Address - State:IN
Mailing Address - Zip Code:46037-9237
Mailing Address - Country:US
Mailing Address - Phone:317-284-8888
Mailing Address - Fax:317-284-8891
Practice Address - Street 1:9865 E 116TH ST
Practice Address - Street 2:SUITE 300
Practice Address - City:FISHERS
Practice Address - State:IN
Practice Address - Zip Code:46037-9237
Practice Address - Country:US
Practice Address - Phone:317-284-8888
Practice Address - Fax:317-284-8891
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-25
Last Update Date:2009-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN07000619A213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200892640AMedicaid
IN000000382914OtherANTHEM BLUE CROSS BLUE SH
IN000000382914OtherANTHEM BLUE CROSS BLUE SH
INT81877Medicare UPIN
IN5783320001Medicare NSC