Provider Demographics
NPI:1225041916
Name:OHIO FOOT AND ANKLE CENTER, LLC
Entity Type:Organization
Organization Name:OHIO FOOT AND ANKLE CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:AARON
Authorized Official - Middle Name:J
Authorized Official - Last Name:CHOKAN
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:330-823-2150
Mailing Address - Street 1:3226 KENT RD
Mailing Address - Street 2:
Mailing Address - City:STOW
Mailing Address - State:OH
Mailing Address - Zip Code:44224-4424
Mailing Address - Country:US
Mailing Address - Phone:330-929-3331
Mailing Address - Fax:330-929-5408
Practice Address - Street 1:1652 SOUTH UNION AVE
Practice Address - Street 2:
Practice Address - City:ALLIANCE
Practice Address - State:OH
Practice Address - Zip Code:44601
Practice Address - Country:US
Practice Address - Phone:330-823-2150
Practice Address - Fax:330-823-8933
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-14
Last Update Date:2010-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH36-00-3273213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2383362Medicaid
OHDC4214OtherMEDICARE RR
OH2536821Medicaid
OH9347682Medicare PIN
OHDC4214OtherMEDICARE RR