Provider Demographics
NPI:1790542579
Name:FOOT & ANKLE OF THE OZARKS LLC
Entity Type:Organization
Organization Name:FOOT & ANKLE OF THE OZARKS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:KARL
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:EWERT
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:209-579-4030
Mailing Address - Street 1:1617 W 26TH ST STE A
Mailing Address - Street 2:
Mailing Address - City:JOPLIN
Mailing Address - State:MO
Mailing Address - Zip Code:64804-0368
Mailing Address - Country:US
Mailing Address - Phone:417-659-9395
Mailing Address - Fax:417-959-9695
Practice Address - Street 1:1617 W 26TH ST STE A
Practice Address - Street 2:
Practice Address - City:JOPLIN
Practice Address - State:MO
Practice Address - Zip Code:64804-0368
Practice Address - Country:US
Practice Address - Phone:417-659-9395
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-28
Last Update Date:2024-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty