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General NPI Number Information
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NPI Number | 1225399363
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Entity Type | Organization
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Legal Business Name | CAPITAL CITY FOOT & ANKLE LLC
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Dates
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Enumeration Date | 06/05/2012
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Last Update Date | 08/15/2013
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Provider Practice Location Address
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Address Line | 1570 FISHINGER RD
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City | COLUMBUS
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State | OH
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Zip | 43221-2114
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Country | US
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Telephone | 614-451-7033
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Fax |
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Provider Business Mailing Address
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Address Line | 1570 FISHINGER RD
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City | COLUMBUS
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State | OH
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Zip | 43221-2114
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Country | US
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Telephone | 614-451-7033
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Fax |
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Authorized Official
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Title or Position | PARTNER
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Name | MARCIA KAY BAYNHAM
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Credential | DPM
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Telephone | 937-597-8303
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | 03618
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License Number State | OH
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