MEDICARE: ASHLAND/MANSFIELD FOOT & ANKLE SPECIALISTS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	213E00000X	Podiatrist
2	213ES0103X	Foot & Ankle Surgery Podiatrist

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1508808395
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ASHLAND/MANSFIELD FOOT & ANKLE SPECIALISTS

Provider Business Mailing Address
First Line	:	PO BOX 22958
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44122-0958
Country	:	US
Telephone Number	:	216-595-9600
Fax Number	:	216-595-9601

Provider Business Practice Location Address
First Line	:	550 S TRIMBLE RD
Second Line	:
City	:	MANSFIELD
State	:	OH
Zip	:	44906-3418
Country	:	US
Telephone Number	:	419-756-1961
Fax Number	:	419-774-9145

Authorized Official
Title or Position	:	PRESIDENT
Name	:	LARRY J ZIMMERMAN
Credential	:	D. P.M.
Telephone Number	:	419-756-1961

Provider Enumeration Date	:	06/13/2006
Last Update Date	:	03/11/2015

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Directions to “ASHLAND/MANSFIELD FOOT & ANKLE SPECIALISTS ” Practice Location

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