Provider Demographics
NPI:1336124528
Name:TOTAL FOOT & ANKLE OF OHIO INC
Entity Type:Organization
Organization Name:TOTAL FOOT & ANKLE OF OHIO INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LEONARD
Authorized Official - Middle Name:R
Authorized Official - Last Name:JANIS
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:614-870-2029
Mailing Address - Street 1:3780 RIDGE MILL DR
Mailing Address - Street 2:
Mailing Address - City:HILLIARD
Mailing Address - State:OH
Mailing Address - Zip Code:43026-7458
Mailing Address - Country:US
Mailing Address - Phone:614-870-2029
Mailing Address - Fax:614-870-1692
Practice Address - Street 1:3780 RIDGE MILL DR
Practice Address - Street 2:
Practice Address - City:HILLIARD
Practice Address - State:OH
Practice Address - Zip Code:43026-7458
Practice Address - Country:US
Practice Address - Phone:614-870-2029
Practice Address - Fax:614-870-1692
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-09
Last Update Date:2010-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2214044Medicaid
OH4137190001Medicare NSC
OH2214044Medicaid