Healthcare Provider Details

I. General information

NPI: 1346792280
Provider Name (Legal Business Name): OHIO FOOT AND ANKLE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/26/2016
Last Update Date: 02/09/2021
Certification Date: 02/09/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

350 W WILSON BRIDGE RD STE 200
WORTHINGTON OH
43085-2217
US

IV. Provider business mailing address

350 W WILSON BRIDGE RD STE 200
WORTHINGTON OH
43085-2217
US

V. Phone/Fax

Practice location:
  • Phone: 614-895-8747
  • Fax:
Mailing address:
  • Phone: 614-895-8747
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332900000X
TaxonomyNon-Pharmacy Dispensing Site
License Number36.003223
License Number StateOH

VIII. Authorized Official

Name: CHRIS MASCIOLA
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 614-895-8747