Provider Demographics
NPI:1801065594
Name:GREENSBURG FOOT CLINIC INC
Entity type:Organization
Organization Name:GREENSBURG FOOT CLINIC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:RAY
Authorized Official - Last Name:SCHILLING
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:812-934-3993
Mailing Address - Street 1:981 STATE ROAD 46 E STE B
Mailing Address - Street 2:
Mailing Address - City:BATESVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47006-7630
Mailing Address - Country:US
Mailing Address - Phone:812-934-3993
Mailing Address - Fax:812-932-3993
Practice Address - Street 1:981 STATE ROAD 46 E STE B
Practice Address - Street 2:
Practice Address - City:BATESVILLE
Practice Address - State:IN
Practice Address - Zip Code:47006-7630
Practice Address - Country:US
Practice Address - Phone:812-934-3993
Practice Address - Fax:812-932-3993
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-27
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN07000444213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100098480Medicaid
IN0227850001Medicare NSC
IN180740Medicare PIN
INT34603Medicare UPIN