Basic Information
Provider Information
NPI: 1699797910
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: FERRO
FirstName: STEPHEN
MiddleName: JAMES
NamePrefix: DR.
NameSuffix:  
Credential: DPM
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 3921 SW CHELMSFORD RD
Address2:  
City: TOPEKA
State: KS
PostalCode: 666101446
CountryCode: US
TelephoneNumber: 7854784445
FaxNumber:  
Practice Location
Address1: 2200 SW GAGE BLVD
Address2: T-M112
City: TOPEKA
State: KS
PostalCode: 666220001
CountryCode: US
TelephoneNumber: 7853503111
FaxNumber: 7853504518
Other Information
ProviderEnumerationDate: 07/24/2006
LastUpdateDate: 07/15/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
213E00000X12-00203KSN Podiatric Medicine & Surgery Service ProvidersPodiatrist 
213ES0131X12-00203KSY Podiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery

No ID Information.


Home