Healthcare Provider Details

I. General information

NPI: 1700889334
Provider Name (Legal Business Name): LEONARD R. JANIS DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/27/2005
Last Update Date: 11/03/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3780 RIDGE MILL DR
HILLIARD OH
43026-7458
US

IV. Provider business mailing address

3780 RIDGE MILL DR
HILLIARD OH
43026-7458
US

V. Phone/Fax

Practice location:
  • Phone: 614-870-2029
  • Fax: 614-870-1692
Mailing address:
  • Phone: 614-870-2029
  • Fax: 614-870-1692

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number36001643
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: