Provider Demographics
NPI:1730305962
Name:COMPREHENSIVE FOOT & ANKLE, SC
Entity Type:Organization
Organization Name:COMPREHENSIVE FOOT & ANKLE, SC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:CINDY
Authorized Official - Middle Name:G
Authorized Official - Last Name:SCHMID
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:715-634-9023
Mailing Address - Street 1:10640 HAYWARD CT
Mailing Address - Street 2:
Mailing Address - City:HAYWARD
Mailing Address - State:WI
Mailing Address - Zip Code:54843-6456
Mailing Address - Country:US
Mailing Address - Phone:715-634-9023
Mailing Address - Fax:715-634-9935
Practice Address - Street 1:415 ELLIS AVE
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:WI
Practice Address - Zip Code:54806-1631
Practice Address - Country:US
Practice Address - Phone:715-634-9023
Practice Address - Fax:715-634-9935
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-17
Last Update Date:2010-12-22
Deactivation Date:2009-10-27
Deactivation Code:
Reactivation Date:2010-12-16
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI43269400Medicaid
WICG4176OtherRAILROAD MEDICARE
WI43269400Medicaid
WI4029420002Medicare NSC