Provider Demographics
NPI:1972528347
Name:MAHRLE, DONALD A (DPM)
Entity Type:Individual
Prefix:
First Name:DONALD
Middle Name:A
Last Name:MAHRLE
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1315 SW 6TH AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66606-1581
Mailing Address - Country:US
Mailing Address - Phone:785-272-7600
Mailing Address - Fax:785-271-5457
Practice Address - Street 1:1315 SW 6TH AVE
Practice Address - Street 2:SUITE A
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66606-1581
Practice Address - Country:US
Practice Address - Phone:785-272-7600
Practice Address - Fax:785-271-5457
Is Sole Proprietor?:No
Enumeration Date:2006-07-13
Last Update Date:2008-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS12-00073213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
P00094620OtherRR MCR
114120OtherBC
5242430001Medicare NSC
114120Medicare PIN
114120OtherBC
KST43844Medicare UPIN