Provider Demographics
NPI:1710042841
Name:HAINGE FOOT & ANKLE CLINIC PC
Entity Type:Organization
Organization Name:HAINGE FOOT & ANKLE CLINIC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:FREDERICK
Authorized Official - Middle Name:W
Authorized Official - Last Name:HAINGE
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:719-574-2000
Mailing Address - Street 1:3920 N UNION BLVD STE 320
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPGS
Mailing Address - State:CO
Mailing Address - Zip Code:80907-4916
Mailing Address - Country:US
Mailing Address - Phone:719-574-2000
Mailing Address - Fax:719-574-6477
Practice Address - Street 1:3920 N UNION BLVD STE 320
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80907-4916
Practice Address - Country:US
Practice Address - Phone:719-574-2000
Practice Address - Fax:719-574-6477
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-27
Last Update Date:2010-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO347213ES0103X
CO593213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
COC437158Medicare PIN
CO5820730001Medicare NSC