Provider Demographics
NPI:1487972873
Name:JOEL D FOSTER DPM PC
Entity type:Organization
Organization Name:JOEL D FOSTER DPM PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALIN SPLECIALIST
Authorized Official - Prefix:MS
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:J
Authorized Official - Last Name:ASHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:816-587-0522
Mailing Address - Street 1:5800 NW PRAIRIE VIEW RD
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64151-2764
Mailing Address - Country:US
Mailing Address - Phone:816-587-0522
Mailing Address - Fax:
Practice Address - Street 1:5800 NW PRAIRIE VIEW RD
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64151-2764
Practice Address - Country:US
Practice Address - Phone:816-587-0522
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-10
Last Update Date:2010-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2000161864213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO305899304Medicaid
MO305899304Medicaid