Healthcare Provider Details

I. General information

NPI: 1508889130
Provider Name (Legal Business Name): FRANK G STODDARD DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/25/2006
Last Update Date: 01/05/2023
Certification Date: 01/05/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

830 AMHERST RD NE SUITE 104
MASSILLON OH
44646-8518
US

IV. Provider business mailing address

830 AMHERST RD NE SUITE 104
MASSILLON OH
44646-8518
US

V. Phone/Fax

Practice location:
  • Phone: 330-833-3668
  • Fax: 330-833-2267
Mailing address:
  • Phone: 330-833-3668
  • Fax: 330-833-2267

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number3130
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: