Provider Demographics
NPI:1588397681
Name:FLINT FOOT AND ANKLE INSTITUTE
Entity type:Organization
Organization Name:FLINT FOOT AND ANKLE INSTITUTE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WESLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:FLINT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-809-6825
Mailing Address - Street 1:6590 W NORWOOD DR
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83704-8765
Mailing Address - Country:US
Mailing Address - Phone:801-809-6825
Mailing Address - Fax:
Practice Address - Street 1:6590 W NORWOOD DR
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83704-8765
Practice Address - Country:US
Practice Address - Phone:208-957-5029
Practice Address - Fax:208-917-8579
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-06
Last Update Date:2022-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XX0004XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryFoot and Ankle SurgeryGroup - Single Specialty