| Prairie Foot & Ankle Pc | |
|
1832 Aspen Ln Ste A, Grand Island, NE 68803-2487 | |
| (308) 646-0077 | |
| (308) 646-0317 |
| Full Name | Prairie Foot & Ankle Pc |
|---|---|
| Type | Facility |
| Speciality | Podiatrist |
| Location | 1832 Aspen Ln Ste A, Grand Island, Nebraska |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528587813 | NPI | - | NPPES |
| 47062497913 | Medicaid | NE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 213E00000X | Podiatrist | (* (Not Available)) | Primary |
| 363LF0000X | Nurse Practitioner - Family | (* (Not Available)) | Secondary |
| Provider Name | Corey S Blackburn |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1528350485 PECOS PAC ID: 6901038579 Enrollment ID: I20140414000694 |
| Provider Name | Karl D Vollers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780201285 PECOS PAC ID: 5294159273 Enrollment ID: I20200723000982 |
| Mailing Address | Practice Location Address |
|---|---|
| Prairie Foot & Ankle Pc Po Box 5823, Grand Island, NE 68802-5823 Ph: (308) 646-0077 | Prairie Foot & Ankle Pc 1832 Aspen Ln Ste A, Grand Island, NE 68803-2487 Ph: (308) 646-0077 |
Foot & Ankle Clinic Of Central Nebraska Pc Podiatrist Medicare: Medicare Enrolled Practice Location: 620 N Diers Ave Ste 100, Grand Island, NE 68803 Phone: 308-381-0404 Fax: 308-381-0408 | |
Dr. Jonathan B Wilson, DPM Podiatrist Medicare: Accepting Medicare Assignments Practice Location: 620 N Diers Ave Ste 100, Grand Island, NE 68803 Phone: 308-381-0404 | |
James E Lewandowski, DPM Podiatrist Medicare: Accepting Medicare Assignments Practice Location: 820 W Division St, Grand Island, NE 68801 Phone: 308-381-7262 Fax: 308-381-4672 | |
Dr. Dusty Lynn Broxterman, DPM Podiatrist Medicare: Accepting Medicare Assignments Practice Location: 620 N Diers Ave Ste 100, Grand Island, NE 68803 Phone: 308-381-0404 | |
Dr. Corey S. Blackburn, D.P.M. Podiatrist Medicare: Accepting Medicare Assignments Practice Location: 1832 Aspen Ln Ste A, Grand Island, NE 68803 Phone: 308-646-0077 Fax: 308-646-0317 | |
Kevin J Larsen, DPM Podiatrist Medicare: Accepting Medicare Assignments Practice Location: 620 N Diers Ave Ste 100, Grand Island, NE 68803 Phone: 308-381-0404 Fax: 308-381-0408 |