Provider Demographics
NPI:1063607471
Name:TOES R US
Entity type:Organization
Organization Name:TOES R US
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPERATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:CHUBINSKI
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:260-747-5572
Mailing Address - Street 1:PO BOX 5007
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:IN
Mailing Address - Zip Code:46750-5007
Mailing Address - Country:US
Mailing Address - Phone:260-356-3668
Mailing Address - Fax:260-356-3723
Practice Address - Street 1:6200 BLUFFTON RD
Practice Address - Street 2:
Practice Address - City:FORT WAYNE
Practice Address - State:IN
Practice Address - Zip Code:46809-2260
Practice Address - Country:US
Practice Address - Phone:260-747-5572
Practice Address - Fax:260-747-8392
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TOES R US
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-09-10
Last Update Date:2007-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN07000406A213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200420BMedicare PIN