NPI 1942549795 · live from the CMS NPI Registry
Ellsworth Foot And Ankle Clinic
Podiatrist, Foot & Ankle Surgery in Riverton, UT. National Provider Identifier 1942549795, active.
NPI record
| NPI | 1942549795 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Podiatrist, Foot & Ankle Surgery 213ES0103X |
| Practice location | 12523 S Creek Meadow Rd Ste 105, Riverton, UT 84065 |
| Practice phone | 801-253-6886 |
| Enumerated | February 13, 2013 |
| Last updated | September 29, 2021 |
| Authorized official | Ryan Ellsworth, Owner, Manager |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Podiatrist, Foot & Ankle Surgery primary | 213ES0103X | 8400193-0501 (UT) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.