Provider Demographics
NPI:1730201757
Name:MID AMERICA PODIATRY ASSOCIATES
Entity type:Organization
Organization Name:MID AMERICA PODIATRY ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LAWRENCE
Authorized Official - Middle Name:M
Authorized Official - Last Name:MANDEL
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:816-444-1100
Mailing Address - Street 1:6709 W 119TH ST
Mailing Address - Street 2:SUITE 416
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66209-2013
Mailing Address - Country:US
Mailing Address - Phone:816-213-3446
Mailing Address - Fax:
Practice Address - Street 1:6675 HOLMES RD
Practice Address - Street 2:SUITE 330
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64131-1150
Practice Address - Country:US
Practice Address - Phone:816-444-1100
Practice Address - Fax:816-444-1475
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty