Provider Demographics
NPI:1225336233
Name:PODIATRY OF HAMILTON INC
Entity Type:Organization
Organization Name:PODIATRY OF HAMILTON INC
Other - Org Name:CENTER FOR FOOT CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KRISTIN
Authorized Official - Middle Name:K
Authorized Official - Last Name:TITKO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-729-4455
Mailing Address - Street 1:7344 HAMILTON AVE
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45231-4322
Mailing Address - Country:US
Mailing Address - Phone:513-729-4455
Mailing Address - Fax:513-728-4739
Practice Address - Street 1:3215 DIXIE HWY
Practice Address - Street 2:
Practice Address - City:ERLANGER
Practice Address - State:KY
Practice Address - Zip Code:41018-1853
Practice Address - Country:US
Practice Address - Phone:859-341-0575
Practice Address - Fax:859-426-4136
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-01
Last Update Date:2015-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY00268213ES0103X
KY268332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY00268OtherSTATE LICENSE
KY80000110Medicaid
KY0664401Medicare PIN
KY80000110Medicaid
KY0950300002Medicare NSC