Provider Demographics
NPI:1902185549
Name:ADVANCED FOOT AND ANKLE SURGEONS,INC
Entity Type:Organization
Organization Name:ADVANCED FOOT AND ANKLE SURGEONS,INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RALPH
Authorized Official - Middle Name:G
Authorized Official - Last Name:OSTING
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:440-537-8312
Mailing Address - Street 1:5111 SEVEN PINES DR
Mailing Address - Street 2:
Mailing Address - City:LORAIN
Mailing Address - State:OH
Mailing Address - Zip Code:44053-3313
Mailing Address - Country:US
Mailing Address - Phone:440-537-8312
Mailing Address - Fax:
Practice Address - Street 1:860 WOODVILLE RD
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:OH
Practice Address - Zip Code:44907-2167
Practice Address - Country:US
Practice Address - Phone:440-537-8312
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-14
Last Update Date:2012-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH36002996213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0055989Medicaid
OH0055989Medicaid
OHH037860Medicare PIN