Provider Demographics
NPI:1437105491
Name:CINCINNATI FOOT CLINIC INC.
Entity Type:Organization
Organization Name:CINCINNATI FOOT CLINIC INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:F
Authorized Official - Last Name:HAYMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:513-385-6946
Mailing Address - Street 1:8111 CHEVIOT ROAD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45247-4013
Mailing Address - Country:US
Mailing Address - Phone:513-385-6946
Mailing Address - Fax:513-385-0363
Practice Address - Street 1:8111 CHEVIOT ROAD
Practice Address - Street 2:SUITE 100
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45247-4013
Practice Address - Country:US
Practice Address - Phone:513-385-6946
Practice Address - Fax:513-385-0363
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-25
Last Update Date:2016-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH36001907213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2853336Medicaid
OHCM5979OtherRAILROAD MEDICARE
OH9189092Medicare PIN
OH2853336Medicaid