Healthcare Provider Details

I. General information

NPI: 1821091000
Provider Name (Legal Business Name): THOMAS VAIL DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/23/2005
Last Update Date: 01/31/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1725 WESTERN AVE STE C
FINDLAY OH
45840-1390
US

IV. Provider business mailing address

1725 WESTERN AVE STE C
FINDLAY OH
45840-1390
US

V. Phone/Fax

Practice location:
  • Phone: 419-423-1888
  • Fax: 419-425-3668
Mailing address:
  • Phone: 419-423-1888
  • Fax: 419-425-3668

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberOH36002326V
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: