Provider Demographics
NPI:1710394739
Name:PARMORE MEDICAL SERVICES LLC
Entity Type:Organization
Organization Name:PARMORE MEDICAL SERVICES LLC
Other - Org Name:EVANSVILLE FOOT AND ANKLE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:K
Authorized Official - Last Name:HUPFER
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:812-475-8900
Mailing Address - Street 1:PO BOX 5475
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47716-5475
Mailing Address - Country:US
Mailing Address - Phone:812-475-8900
Mailing Address - Fax:812-475-0024
Practice Address - Street 1:3700 BELLEMEADE AVE STE 117
Practice Address - Street 2:
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47714-0106
Practice Address - Country:US
Practice Address - Phone:812-475-8900
Practice Address - Fax:812-475-0024
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-22
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN07000766A213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200936500AMedicaid
IN200936500AMedicaid
IN7338450001Medicare NSC