Provider Demographics
NPI:1659364503
Name:OHIO FOOT & ANKLE, INC
Entity Type:Organization
Organization Name:OHIO FOOT & ANKLE, INC
Other - Org Name:ORTHOPEDIC FOOT AND ANKLE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CHRIS
Authorized Official - Middle Name:
Authorized Official - Last Name:MASCIOLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-895-8747
Mailing Address - Street 1:350 W WILSON BRIDGE RD STE 200
Mailing Address - Street 2:
Mailing Address - City:WORTHINGTON
Mailing Address - State:OH
Mailing Address - Zip Code:43085-2217
Mailing Address - Country:US
Mailing Address - Phone:614-895-8747
Mailing Address - Fax:614-895-8810
Practice Address - Street 1:350 W WILSON BRIDGE RD STE 200
Practice Address - Street 2:
Practice Address - City:WORTHINGTON
Practice Address - State:OH
Practice Address - Zip Code:43085-2217
Practice Address - Country:US
Practice Address - Phone:614-895-8747
Practice Address - Fax:614-895-8810
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-25
Last Update Date:2022-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XX0004XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryFoot and Ankle SurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2164965Medicaid
OH1281380001Medicare NSC
OHOR9300431Medicare ID - Type UnspecifiedGROUP MDCR