Provider Demographics
NPI:1588368476
Name:CAPE FOOT AND ANKLE LLC
Entity type:Organization
Organization Name:CAPE FOOT AND ANKLE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PODIATRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:LIFFERTH
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:573-334-1080
Mailing Address - Street 1:2128 WILLIAM ST # 120
Mailing Address - Street 2:
Mailing Address - City:CAPE GIRARDEAU
Mailing Address - State:MO
Mailing Address - Zip Code:63703-5847
Mailing Address - Country:US
Mailing Address - Phone:385-202-5544
Mailing Address - Fax:
Practice Address - Street 1:2917 INDEPENDENCE ST STE 300
Practice Address - Street 2:
Practice Address - City:CAPE GIRARDEAU
Practice Address - State:MO
Practice Address - Zip Code:63703-5025
Practice Address - Country:US
Practice Address - Phone:573-334-1080
Practice Address - Fax:573-312-3542
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-27
Last Update Date:2023-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty