1427629864 NPI number — FOOT AND ANKLE SPECIALISTS OF CENTRAL OHIO LLC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1427629864 NPI number — FOOT AND ANKLE SPECIALISTS OF CENTRAL OHIO LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
FOOT AND ANKLE SPECIALISTS OF CENTRAL OHIO LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1427629864
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/07/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
426 BEECHER RD STE A
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GAHANNA
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
43230-3506
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
614-939-9330
Provider Business Mailing Address Fax Number:
614-939-9299

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6670 PERIMETER DR STE 240
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DUBLIN
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
43016-8058
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
614-339-2000
Provider Business Practice Location Address Fax Number:
614-339-2003
Provider Enumeration Date:
07/07/2021

Additional Information

Authorized Official

Authorized Official Last Name:
GURWIN
Authorized Official First Name:
SCOTT
Authorized Official Middle Name:
Authorized Official Title or Position:
AUTHORIZED OFFICIAL
Authorized Official Telephone Number:
614-939-9330

Provider Taxonomy Codes

  • Taxonomy code: 213ES0103X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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