Provider Demographics
NPI:1932156270
Name:SOUTHWEST FOOT AND ANKLE ASSOCIATES, INC
Entity Type:Organization
Organization Name:SOUTHWEST FOOT AND ANKLE ASSOCIATES, INC
Other - Org Name:SOUTHWEST FOOT AND ANKLE ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:R
Authorized Official - Last Name:HOLFINGER
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:440-816-2735
Mailing Address - Street 1:7255 OLD OAK BLVD
Mailing Address - Street 2:SUITE C308
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44130-3329
Mailing Address - Country:US
Mailing Address - Phone:440-816-2735
Mailing Address - Fax:440-816-5306
Practice Address - Street 1:7255 OLD OAK BLVD
Practice Address - Street 2:SUITE C308
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44130-3329
Practice Address - Country:US
Practice Address - Phone:440-816-2735
Practice Address - Fax:440-816-5306
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-30
Last Update Date:2014-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHD7400OtherRAILROAD MEDICARE
OH2213590Medicaid
OHP01887OtherSUMMA
OH104855OtherKAISER
OH4318450001OtherADMINISTAR
OH4318450001OtherADMINISTAR
OH4318450001OtherADMINISTAR
OH=========00OtherOHIO WORKERS COMP