Provider Demographics
NPI:1912022674
Name:HARTVILLE FOOT & ANKLE ASSOCIATES, INC.
Entity Type:Organization
Organization Name:HARTVILLE FOOT & ANKLE ASSOCIATES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:
Authorized Official - Last Name:LUBELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-877-0220
Mailing Address - Street 1:800 W. MAPLE
Mailing Address - Street 2:
Mailing Address - City:HARTVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44632-8505
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:800 W MAPLE ST
Practice Address - Street 2:
Practice Address - City:HARTVILLE
Practice Address - State:OH
Practice Address - Zip Code:44632-8505
Practice Address - Country:US
Practice Address - Phone:330-877-0220
Practice Address - Fax:330-877-0228
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0869109Medicaid
OH0869109Medicaid