Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mr. Jerry M Liddell, DPM

Individual provider Foot & Ankle Surgery Podiatrist · NPI 1700872611

Mr. Jerry M Liddell, DPM is a Podiatry in Saint Louis, Missouri. Graduated from Kent State University College of Podiatric Medicine in 2002, 24 years ago. Practices with Washington University, a 2,986-clinician group and accepts Medicare assignment. Licensed in Missouri.

Years since qualifying
24
Trained at
Kent State University College of Podiatric Medicine
Licensed in
MO
In the registry since
2005
What do these letters mean?
DPM — Doctor of Podiatric Medicine
A foot and ankle physician and surgeon.

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Practice location Address checks out

4901 Forest Park Ave Div Surg Accs Podiatry Ste 420
Saint Louis, MO 63108-1495
Phone: (314) 747-4769
Fax: (888) 824-2176
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Foot & Ankle Surgery Podiatrist (primary) Taxonomy 213ES0103X · Licence 2005018735 (MO)

Record details

NPI number1700872611
Entity typeIndividual (Type 1)
GenderMale
Credentials DPM
Sole proprietorNo
NPI enumeratedSeptember 26, 2005
Last updated in NPPESApril 17, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPODIATRY
Medical schoolKENT STATE UNIVERSITY COLLEGE OF PODIATRIC MEDICINE
Graduated 2002 (24 years in practice)
Group practice Washington University — 2986 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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