Provider Demographics
NPI:1760785307
Name:UNIVERSITY PODIATRY ASSOCIATES, LLP
Entity Type:Organization
Organization Name:UNIVERSITY PODIATRY ASSOCIATES, LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PARTER
Authorized Official - Prefix:
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:
Authorized Official - Last Name:KALKER
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:608-831-8086
Mailing Address - Street 1:6255 UNIVERSITY AVE STE 204
Mailing Address - Street 2:
Mailing Address - City:MIDDLETON
Mailing Address - State:WI
Mailing Address - Zip Code:53562-3485
Mailing Address - Country:US
Mailing Address - Phone:608-831-8086
Mailing Address - Fax:608-442-0126
Practice Address - Street 1:6255 UNIVERSITY AVE STE 204
Practice Address - Street 2:
Practice Address - City:MIDDLETON
Practice Address - State:WI
Practice Address - Zip Code:53562-3485
Practice Address - Country:US
Practice Address - Phone:608-831-8086
Practice Address - Fax:608-442-0126
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-20
Last Update Date:2011-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
5043250001Medicare NSC