Provider Demographics
NPI:1073713327
Name:DAVID A.GAMES, LL
Entity Type:Organization
Organization Name:DAVID A.GAMES, LL
Other - Org Name:FOOT ORTHOTICS OF SOUTHEAST OHIO, LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:ANDREW
Authorized Official - Last Name:GAMES
Authorized Official - Suffix:II
Authorized Official - Credentials:LPED CPED
Authorized Official - Phone:740-452-6400
Mailing Address - Street 1:PO BOX 2516
Mailing Address - Street 2:
Mailing Address - City:ZANESVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43702-2516
Mailing Address - Country:US
Mailing Address - Phone:740-452-6400
Mailing Address - Fax:740-452-3900
Practice Address - Street 1:760 LINDEN AVE
Practice Address - Street 2:
Practice Address - City:ZANESVILLE
Practice Address - State:OH
Practice Address - Zip Code:43701-3355
Practice Address - Country:US
Practice Address - Phone:740-452-6400
Practice Address - Fax:740-452-3900
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-24
Last Update Date:2012-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH100332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2454375Medicaid
OH4835790001Medicare NSC