| Organization Name: | MID-WEST PODIATRY AND ASSOCIATES |
| NPI Number: | 1972669976 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | SANDY PIKE (ADMINISTRATOR) |
| Mailing Address: | 990 Park Dr Ste Genevieve |
| State: | MO US |
| Postal Code: | 636701539 |
| Phone Number: | 8005629714 |
| Fax Number: | 3144325105 |
| NPI Enumeration Date: | 12/28/2006 |
| NPI Last Update Date: | 06/19/2013 |
| 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: | |