Healthcare Provider Details

I. General information

NPI: 1235152448
Provider Name (Legal Business Name): FOOT SPECIALISTS OF GREATER CINCINNATI
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/26/2006
Last Update Date: 11/10/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2865 CHANCELLOR DR SUITE 205
CRESTVIEW HILLS KY
41017-3931
US

IV. Provider business mailing address

2865 CHANCELLOR DR SUITE 205
CRESTVIEW HILLS KY
41017-3931
US

V. Phone/Fax

Practice location:
  • Phone: 859-341-9900
  • Fax: 859-341-1649
Mailing address:
  • Phone: 859-341-9900
  • Fax: 859-341-1649

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0131X
TaxonomyFoot Surgery Podiatrist
License Number
License Number State

VIII. Authorized Official

Name: CHARLES M TIRONE
Title or Position: PRESIDENT
Credential:
Phone: 859-341-9900