Healthcare Provider Details

I. General information

NPI: 1588697767
Provider Name (Legal Business Name): DELAWARE PODIATRY CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/09/2006
Last Update Date: 03/10/2026
Certification Date: 03/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

357 W CENTRAL AVE
DELAWARE OH
43015-1476
US

IV. Provider business mailing address

575 COPELAND MILL RD STE 2F
WESTERVILLE OH
43081-8977
US

V. Phone/Fax

Practice location:
  • Phone: 740-369-3071
  • Fax: 740-369-5188
Mailing address:
  • Phone: 614-891-2828
  • Fax: 614-891-5411

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213EP1101X
TaxonomyPrimary Podiatric Medicine Podiatrist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State

VIII. Authorized Official

Name: TINA L CHRISTY
Title or Position: OFFICE MANAGER
Credential:
Phone: 614-891-2828