Provider Demographics
NPI:1114045978
Name:FAMILY FOOT AND ANKLE ASSOCIATES INC
Entity Type:Organization
Organization Name:FAMILY FOOT AND ANKLE ASSOCIATES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:S
Authorized Official - Last Name:SELLERS
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:419-423-9113
Mailing Address - Street 1:1733 WESTERN AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:FINDLAY
Mailing Address - State:OH
Mailing Address - Zip Code:45840-1346
Mailing Address - Country:US
Mailing Address - Phone:419-423-9113
Mailing Address - Fax:419-423-8377
Practice Address - Street 1:1733 WESTERN AVE
Practice Address - Street 2:SUITE B
Practice Address - City:FINDLAY
Practice Address - State:OH
Practice Address - Zip Code:45840-1346
Practice Address - Country:US
Practice Address - Phone:419-423-9113
Practice Address - Fax:419-423-8377
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-27
Last Update Date:2010-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0240368Medicaid
OH1119680001Medicare NSC
OHCC8716Medicare PIN
OH9284213Medicare PIN