Provider Demographics
NPI:1407024672
Name:PODIATRY OF HAMILTON INC
Entity Type:Organization
Organization Name:PODIATRY OF HAMILTON INC
Other - Org Name:FOOT CARE CENTER
Other - Org Type:Other Name
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:DPM
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:513-577-7261
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:513-729-4455
Practice Address - Fax:513-577-7261
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-11
Last Update Date:2014-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY00114213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY80001142Medicaid
KY0172610001Medicare NSC
KYT54175Medicare UPIN
KY80001142Medicaid