Provider Demographics
NPI:1033113683
Name:FEET FIRST PODIATRY INC.
Entity Type:Organization
Organization Name:FEET FIRST PODIATRY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PODIATRST OWNER
Authorized Official - Prefix:
Authorized Official - First Name:EUGENE
Authorized Official - Middle Name:
Authorized Official - Last Name:ZOOG
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:614-837-8000
Mailing Address - Street 1:6200 PLEASANT AVE
Mailing Address - Street 2:SUITE 3
Mailing Address - City:FAIRFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:45014-4670
Mailing Address - Country:US
Mailing Address - Phone:513-829-9333
Mailing Address - Fax:513-858-7827
Practice Address - Street 1:8563 REFUGEE RD
Practice Address - Street 2:
Practice Address - City:PICKERINGTON
Practice Address - State:OH
Practice Address - Zip Code:43147-9639
Practice Address - Country:US
Practice Address - Phone:614-837-8000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-10
Last Update Date:2016-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH36002667213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2086460Medicaid
OH2091534Medicaid
OHCI1452OtherRAILROAD MEDICARE
OH2509137Medicaid
OH2091534Medicaid
OH9299024Medicare PIN
OH9299023Medicare PIN
OH2509137Medicaid