Healthcare Provider Details
I. General information
NPI: 1265830566
Provider Name (Legal Business Name): OHIO PODIATRIC PHYSICIANS AND SURGEONS GROUP, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/18/2014
Last Update Date: 12/22/2014
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1275 OLENTANGY RIVER RD SUITE 120
COLUMBUS OH
43212-3119
US
IV. Provider business mailing address
1275 OLENTANGY RIVER RD SUITE 120
COLUMBUS OH
43212-3119
US
V. Phone/Fax
- Phone: 614-291-5555
- Fax: 614-291-7720
- Phone: 614-291-5555
- Fax: 614-291-7720
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 213ES0103X |
| Taxonomy | Foot & Ankle Surgery Podiatrist |
| License Number | 36003370K |
| License Number State | OH |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 213ES0131X |
| Taxonomy | Foot Surgery Podiatrist |
| License Number | 36003370K |
| License Number State | OH |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 213EP1101X |
| Taxonomy | Primary Podiatric Medicine Podiatrist |
| License Number | 36003370K |
| License Number State | OH |
VIII. Authorized Official
Name: DR.
DAVID
BENJAMIN
KAPLANSKY
Title or Position: PHYSICIAN
Credential: DPM
Phone: 614-291-5555