Provider Demographics
NPI:1821460676
Name:A STEP AHEAD FOOT AND ANKLE CLINIC
Entity Type:Organization
Organization Name:A STEP AHEAD FOOT AND ANKLE CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CALVIN
Authorized Official - Middle Name:D
Authorized Official - Last Name:BAIZE
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:870-834-5249
Mailing Address - Street 1:2375 WHITE DR
Mailing Address - Street 2:
Mailing Address - City:BATESVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72501-9473
Mailing Address - Country:US
Mailing Address - Phone:870-345-3180
Mailing Address - Fax:870-345-3180
Practice Address - Street 1:2375 WHITE DR
Practice Address - Street 2:
Practice Address - City:BATESVILLE
Practice Address - State:AR
Practice Address - Zip Code:72501-9473
Practice Address - Country:US
Practice Address - Phone:870-345-3180
Practice Address - Fax:870-345-3180
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-20
Last Update Date:2021-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR264213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR214952717Medicaid