Provider Demographics
NPI:1780862474
Name:ANKLE & FOOT ASSOCIATES PLLC
Entity Type:Organization
Organization Name:ANKLE & FOOT ASSOCIATES PLLC
Other - Org Name:WILLIAM C STYCH
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:CORRY
Authorized Official - Last Name:STYCH
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:231-935-0666
Mailing Address - Street 1:4001 W ROYAL DR
Mailing Address - Street 2:
Mailing Address - City:TRAVERSE CITY
Mailing Address - State:MI
Mailing Address - Zip Code:49684-8965
Mailing Address - Country:US
Mailing Address - Phone:231-935-0666
Mailing Address - Fax:231-935-0317
Practice Address - Street 1:4001 W ROYAL DR
Practice Address - Street 2:
Practice Address - City:TRAVERSE CITY
Practice Address - State:MI
Practice Address - Zip Code:49684-8965
Practice Address - Country:US
Practice Address - Phone:231-935-0666
Practice Address - Fax:231-935-0317
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-05
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5901001631213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI2846782Medicaid
MI0715920001Medicare NSC
MIU31860Medicare UPIN
MI2846782Medicaid
MI5285002Medicare Oscar/Certification