Provider Demographics
NPI:1669575734
Name:FOOT & ANKLE SPECIALISTS OF
Entity type:Organization
Organization Name:FOOT & ANKLE SPECIALISTS OF
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:GURWIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-939-9330
Mailing Address - Street 1:426 BEECHER RD
Mailing Address - Street 2:STEA
Mailing Address - City:GAHANNA
Mailing Address - State:OH
Mailing Address - Zip Code:43230-1797
Mailing Address - Country:US
Mailing Address - Phone:614-939-9330
Mailing Address - Fax:614-939-9299
Practice Address - Street 1:426 BEECHER RD
Practice Address - Street 2:STEA
Practice Address - City:GAHANNA
Practice Address - State:OH
Practice Address - Zip Code:43230-1797
Practice Address - Country:US
Practice Address - Phone:614-939-9330
Practice Address - Fax:614-939-9299
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-06
Last Update Date:2010-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH36002584213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH9354281OtherMEDICARE PTAN
OHP00234254OtherRRMCR
OH480012352OtherRRMCR
OHU19158Medicare UPIN
OH9354281OtherMEDICARE PTAN