Provider Demographics
NPI:1407900418
Name:CAPITAL FOOT CARE, INC.
Entity Type:Organization
Organization Name:CAPITAL FOOT CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PODIATRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:COHEN
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:614-766-6556
Mailing Address - Street 1:7211 SAWMILL RD
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:OH
Mailing Address - Zip Code:43016-5008
Mailing Address - Country:US
Mailing Address - Phone:614-766-6556
Mailing Address - Fax:614-766-6556
Practice Address - Street 1:7211 SAWMILL RD
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:OH
Practice Address - Zip Code:43016-5008
Practice Address - Country:US
Practice Address - Phone:614-766-6556
Practice Address - Fax:614-766-6556
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-23
Last Update Date:2012-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH36.002049213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
=========OtherEIN
OH=========00OtherWORKMAN'S COMPENSATION
OHCA9264611Medicare ID - Type Unspecified