Healthcare Provider Details

I. General information

NPI: 1366452708
Provider Name (Legal Business Name): OHIO FOOT AND ANKLE CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/08/2006
Last Update Date: 11/11/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1700 BOETTLER RD SUITE 150
UNIONTOWN OH
44685-7792
US

IV. Provider business mailing address

3226 KENT RD
STOW OH
44224-4424
US

V. Phone/Fax

Practice location:
  • Phone: 330-899-0988
  • Fax: 330-899-1101
Mailing address:
  • Phone: 330-929-3331
  • Fax: 330-929-5408

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number36-00-3273
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: AARON J CHOKAN
Title or Position: PRESIDENT
Credential: DPM
Phone: 330-899-0988