Peninsula Podiatry Llc

LBN: Peninsula Podiatry Llc
Peninsula Podiatry Llc is an health care organization with primary practice located at Bldg 4 2 30 North 18Th Avenue, Sturgeon Bay WI 54235-3207. The organization recently has 2 registered licenses in different health care specialties including Podiatric Medicine & Surgery Service Providers / Podiatrist, Suppliers / Durable Medical Equipment & Medical Supplies. Podiatric Medicine & Surgery Service Providers / Podiatrist is the primary health care specialty. Peninsula Podiatry Llc can be contacted via phone (920) 743-6668, or through Burkart, Bradley Gerard via phone (920) 743-6668.

Contact Information

Primary practice address
Bldg 4 2 30 North 18Th Avenue Sturgeon Bay WI 54235-3207
Phone: (920) 743-6668
Fax: (920) 743-9222
Website:
Map and Directions
Authorized official contact:
Name: Burkart, Bradley Gerard Doctor of Podiatric Medicine (DPM)
Phone: (920) 743-6668

Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Podiatrist 213E00000X Wisconsin
Suppliers / Durable Medical Equipment & Medical Supplies 332B00000X Wisconsin

Profile Details

NPI number 1255425088
LBN Legal business name Peninsula Podiatry Llc
DBA Doing business as
Authorized official Burkart, Bradley Gerard Doctor of Podiatric Medicine (DPM)
Entity Organization
Organization subpart 1 No
Enumeration date Oct 3rd, 2006
Last updated Feb 5th, 2008 - about 17 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1255425088 NPPES
Wisconsin MEDICAID 43267300

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