Provider Demographics
NPI:1619008653
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:VICE PRESIDENT
Authorized Official - Prefix:
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 1:10475 READING RD
Mailing Address - Street 2:#404
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45241-2563
Mailing Address - Country:US
Mailing Address - Phone:513-729-4455
Mailing Address - Fax:513-563-7761
Practice Address - Street 1:111 WELLINGTON PL
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45219-1758
Practice Address - Country:US
Practice Address - Phone:513-729-4455
Practice Address - Fax:513-563-7761
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-09
Last Update Date:2007-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0950300001OtherDMERC
OH0950300001Medicare NSC
OH0950300001OtherDMERC
U46609Medicare UPIN