Provider Demographics
NPI:1669643136
Name:NEIL SAUNDERS DPM
Entity Type:Organization
Organization Name:NEIL SAUNDERS DPM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NEIL
Authorized Official - Middle Name:E
Authorized Official - Last Name:SAUNDERS
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:419-474-3338
Mailing Address - Street 1:3030 W SYLVANIA AVE
Mailing Address - Street 2:SUITE 105
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43613-4100
Mailing Address - Country:US
Mailing Address - Phone:419-474-3338
Mailing Address - Fax:419-474-5193
Practice Address - Street 1:2735 NAVARRE AVE
Practice Address - Street 2:SUITE 101, BLDG A
Practice Address - City:OREGON
Practice Address - State:OH
Practice Address - Zip Code:43616-3275
Practice Address - Country:US
Practice Address - Phone:419-691-3668
Practice Address - Fax:419-474-5193
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-12
Last Update Date:2011-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH36002506213ES0103X
OH36.002506332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized EquipmentGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0738983Medicaid
OH2521640002Medicare NSC