Provider Demographics
NPI:1942991716
Name:MATTHEW THOMAS FOOT & ANKLE CLINIC PLLC
Entity Type:Organization
Organization Name:MATTHEW THOMAS FOOT & ANKLE CLINIC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:REED
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:719-867-8828
Mailing Address - Street 1:2620 TENDERFOOT HILL ST STE 200
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80906-8356
Mailing Address - Country:US
Mailing Address - Phone:719-867-8838
Mailing Address - Fax:719-867-8816
Practice Address - Street 1:2620 TENDERFOOT HILL ST STE 200
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80906-8356
Practice Address - Country:US
Practice Address - Phone:719-867-8838
Practice Address - Fax:719-867-8816
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-15
Last Update Date:2023-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Multi-Specialty