Healthcare Provider Details

I. General information

NPI: 1861511008
Provider Name (Legal Business Name): ORTHOPAEDIC INSTITUTE OF OHIO, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/28/2007
Last Update Date: 06/17/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1275 GREENVILLE RD
SAINT MARYS OH
45885-9352
US

IV. Provider business mailing address

801 MEDICAL DR SUITE A
LIMA OH
45804-4099
US

V. Phone/Fax

Practice location:
  • Phone: 419-394-4636
  • Fax:
Mailing address:
  • Phone: 419-222-6622
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: MRS. KATHY ACKERMAN
Title or Position: ADMINISTRATOR
Credential:
Phone: 419-222-6622