| Wisconsin Foot Center, Llc | |
|
6130 S 108th Street, Hales Corners, WI 53130-2525 | |
| (414) 425-8400 | |
| (414) 425-8425 |
| Full Name | Wisconsin Foot Center, Llc |
|---|---|
| Type | Facility |
| Speciality | Podiatrist |
| Location | 6130 S 108th Street, Hales Corners, Wisconsin |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326299553 | NPI | - | NPPES |
| DO9353 | Other | WI | RAIL ROAD MEDICARE GROUP PTAN # |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 213E00000X | Podiatrist | 896-025 (Wisconsin) | Primary |
| Provider Name | David John Guhl |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1689770877 PECOS PAC ID: 5991600041 Enrollment ID: I20031203000263 |
| Provider Name | Andrew J Marso |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1699753848 PECOS PAC ID: 9830132471 Enrollment ID: I20050606000465 |
| Mailing Address | Practice Location Address |
|---|---|
| Wisconsin Foot Center, Llc 6130 S 108th Street, Hales Corners, WI 53130-2525 Ph: (414) 425-8400 | Wisconsin Foot Center, Llc 6130 S 108th Street, Hales Corners, WI 53130-2525 Ph: (414) 425-8400 |
James C. Boudreau, Dpm, Sc Podiatrist Medicare: Not Enrolled in Medicare Practice Location: 6191 S. 108th St., Hales Corners, WI 53130 Phone: 414-425-5140 Fax: 414-425-7960 | |
Dr. Theodore M. Ludwig, D.P.M. Podiatrist Medicare: Not Enrolled in Medicare Practice Location: 6191 S 108th St, Hales Corners, WI 53130 Phone: 414-425-5140 Fax: 414-425-7960 | |
Dr. Andrew J Marso, DPM Podiatrist Medicare: Accepting Medicare Assignments Practice Location: 6130 S 108th Street, Hales Corners, WI 53130 Phone: 414-425-8400 Fax: 414-425-8425 |