Provider Demographics
NPI:1396841532
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:PRACTICE ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:LONA
Authorized Official - Middle Name:K
Authorized Official - Last Name:BELTZ
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:513-644-7913
Mailing Address - Street 1:6770 CINCINNATI DAYTON RD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:LIBERTY TOWNSHIP
Mailing Address - State:OH
Mailing Address - Zip Code:45044-9318
Mailing Address - Country:US
Mailing Address - Phone:513-729-4455
Mailing Address - Fax:513-644-4993
Practice Address - Street 1:6770 CINCINNATI DAYTON RD
Practice Address - Street 2:SUITE 201
Practice Address - City:LIBERTY TOWNSHIP
Practice Address - State:OH
Practice Address - Zip Code:45044-9318
Practice Address - Country:US
Practice Address - Phone:513-729-4455
Practice Address - Fax:513-644-4993
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-15
Last Update Date:2016-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1359213E00000X
OH2794213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KYCH7777OtherRAIL ROAD MEDICARE
OHCA0586OtherRAIL ROAD MEDICARE
OH2207767Medicaid
KY7100325490Medicaid
KY6644Medicare PIN
KYCH7777OtherRAIL ROAD MEDICARE
OH9263181Medicare PIN
OH4213131Medicare PIN