Healthcare Provider Details

I. General information

NPI: 1225336233
Provider Name (Legal Business Name): PODIATRY OF HAMILTON INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/01/2011
Last Update Date: 03/27/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3215 DIXIE HWY
ERLANGER KY
41018-1853
US

IV. Provider business mailing address

7344 HAMILTON AVE
CINCINNATI OH
45231-4322
US

V. Phone/Fax

Practice location:
  • Phone: 859-341-0575
  • Fax: 859-426-4136
Mailing address:
  • Phone: 513-729-4455
  • Fax: 513-728-4739

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number00268
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number268
License Number StateKY

VIII. Authorized Official

Name: DR. KRISTIN K TITKO
Title or Position: PRESIDENT
Credential:
Phone: 513-729-4455