MEDICARE: THE FOOT & ANKLE HEALTH CENTER

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	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	:	1548327059
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE FOOT & ANKLE HEALTH CENTER

Provider Business Mailing Address
First Line	:	4694 CEMETERY RD PMB #331
Second Line	:
City	:	HILLIARD
State	:	OH
Zip	:	43026-1124
Country	:	US
Telephone Number	:	614-875-5233
Fax Number	:	614-875-1224

Provider Business Practice Location Address
First Line	:	3841 BROADWAY
Second Line	:
City	:	GROVE CITY
State	:	OH
Zip	:	43123-2206
Country	:	US
Telephone Number	:	614-875-5233
Fax Number	:	614-875-1224

Authorized Official
Title or Position	:	OWNER
Name	:	KYLE HOOGENDOORN
Credential	:	DPM
Telephone Number	:	614-875-5233

Provider Enumeration Date	:	01/03/2007
Last Update Date	:	08/22/2020

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Directions to “THE FOOT & ANKLE HEALTH CENTER ” Practice Location

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