Provider Demographics
NPI:1306036371
Name:DR. BRIAN J. ALTMAN & ASSOCIATES, P.C.
Entity Type:Organization
Organization Name:DR. BRIAN J. ALTMAN & ASSOCIATES, P.C.
Other - Org Name:TRI-STATE FOOT & ANKLE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:J
Authorized Official - Last Name:ALTMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:765-962-0521
Mailing Address - Street 1:3923 CHESTER BLVD
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:IN
Mailing Address - Zip Code:47374-1085
Mailing Address - Country:US
Mailing Address - Phone:765-962-0521
Mailing Address - Fax:765-962-1610
Practice Address - Street 1:810 OHIO PIKE STE B
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45245-2219
Practice Address - Country:US
Practice Address - Phone:513-232-8880
Practice Address - Fax:513-947-8972
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-26
Last Update Date:2012-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH36.003468213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty