Provider Demographics
NPI:1457553935
Name:KINSMAN FOOT & ANKLE CENTER INC.
Entity Type:Organization
Organization Name:KINSMAN FOOT & ANKLE CENTER INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PODIATRISTSUPPLIER
Authorized Official - Prefix:
Authorized Official - First Name:SAI
Authorized Official - Middle Name:
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:216-283-2800
Mailing Address - Street 1:11602 KINSMAN RD
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44120-4318
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:11602 KINSMAN RD
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44120-4318
Practice Address - Country:US
Practice Address - Phone:216-283-2800
Practice Address - Fax:216-283-1324
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-05
Last Update Date:2011-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH36003361-L332B00000X
OH36003302332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHP00464561OtherRAILROAD MEDICARE
OHU97963Medicare UPIN
OHU86535Medicare UPIN
OH5728320001Medicare NSC