Provider Demographics
NPI:1194037473
Name:FORD, CARLI J (DPM)
Entity Type:Individual
Prefix:
First Name:CARLI
Middle Name:J
Last Name:FORD
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:CARLI
Other - Middle Name:J
Other - Last Name:SEIDNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPM
Mailing Address - Street 1:420 N. JAMES RD.
Mailing Address - Street 2:SURGERY/PODIATRY, 2ND FLOOR
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43219-1834
Mailing Address - Country:US
Mailing Address - Phone:614-257-5200
Mailing Address - Fax:
Practice Address - Street 1:420 N. JAMES RD.
Practice Address - Street 2:SURGERY/PODIATRY, 2ND FLOOR
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43219-1834
Practice Address - Country:US
Practice Address - Phone:614-257-5200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-02
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH36003607213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH008113557Medicaid
H216151Medicare PIN