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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

BART WAYNE GASTWIRTH, D.P.M.

Active Sole Proprietor

BART WAYNE GASTWIRTH, D.P.M. is a Foot Surgery Podiatrist healthcare provider located in CHAMPAIGN, Illinois. NPI 1568459030 is currently active in the NPPES registry. Verify at CMS.

Foot Surgery Podiatrist · CHAMPAIGN, IL

Registration Details

NPI Number
1568459030
Provider Type
Individual
Gender
Male
NPI Issued
Sep 30, 2005 (20.892358371331 yrs)
Last Updated
Oct 18, 2016
Licenses
016-002956 (IL)
016-002956 (IL)
016-0002956 (IL)
016-002956 (IL)
016-0002956 (IL)
Sole Proprietor
Yes

Practice Information

Address
1802 S MATTIS AVE
CHAMPAIGN, IL, 618215923
Browse IL providers · Browse ZIP 61821
Phone
2173833260
Fax
2173834459
Primary Specialty
Foot Surgery Podiatrist
213ES0131X
Additional Specialty
Foot Surgery Podiatrist
Additional Specialty
Sports Medicine Podiatrist
Additional Specialty
Radiology Podiatrist
Additional Specialty
Podiatrist
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.