Healthcare Provider Details

I. General information

NPI: 1770737801
Provider Name (Legal Business Name): ADVANCED FOOT SURGEONS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/17/2008
Last Update Date: 11/17/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4342 GALLIA ST SUITE A
NEW BOSTON OH
45662-5562
US

IV. Provider business mailing address

4342 GALLIA ST SUITE A
NEW BOSTON OH
45662-5562
US

V. Phone/Fax

Practice location:
  • Phone: 740-456-5700
  • Fax: 740-456-5711
Mailing address:
  • Phone: 740-456-5700
  • Fax: 740-456-5711

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number360022515
License Number StateOH

VIII. Authorized Official

Name: JEFFREY S. SCHUSSLER
Title or Position: OWNER
Credential: DPM
Phone: 513-535-3338