| Organization Name: | MIDWEST FOOT & ANKLE SPECIALISTS, LLC |
| NPI Number: | 1376718031 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | WILLIAM NICHOLS (OWNER) |
| Mailing Address: | 705 18th St E Glencoe |
| State: | MN US |
| Postal Code: | 553361432 |
| Phone Number: | 9528904061 |
| Fax Number: | |
| NPI Enumeration Date: | 04/24/2008 |
| NPI Last Update Date: | 02/02/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 213ES0103X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
| Taxonomy Classification: | Podiatrist |
| Taxonomy Specialization: | Foot & Ankle Surgery |
| Taxonomy Definition: | |