Provider Demographics
NPI:1205113230
Name:HEARTLAND PODIATRY, P.C.
Entity type:Organization
Organization Name:HEARTLAND PODIATRY, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDEN
Authorized Official - Prefix:DR
Authorized Official - First Name:ARTHUR
Authorized Official - Middle Name:M
Authorized Official - Last Name:WEISMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:816-478-3338
Mailing Address - Street 1:2406 E RD MIZE RD
Mailing Address - Street 2:
Mailing Address - City:INDEPENDENCE
Mailing Address - State:MO
Mailing Address - Zip Code:64057-1808
Mailing Address - Country:US
Mailing Address - Phone:816-478-3338
Mailing Address - Fax:816-373-0054
Practice Address - Street 1:1161 SE OLDHAM PARKWAY
Practice Address - Street 2:
Practice Address - City:LEES SUMMIT
Practice Address - State:MO
Practice Address - Zip Code:64081
Practice Address - Country:US
Practice Address - Phone:816-478-3338
Practice Address - Fax:816-373-0054
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HEARTLAND PODIATRY, P.C.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-11-04
Last Update Date:2018-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO000565213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty