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General NPI Number Information
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NPI Number | 1609951482
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Entity Type | Organization
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Legal Business Name | TRI COUNTY FOOT AND ANKLE ASSOCIATES INC
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Dates
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Enumeration Date | 10/27/2006
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Last Update Date | 07/17/2008
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Provider Practice Location Address
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Address Line | 301 DR MIKE CLOUSE DRIVE
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City | SOMERSET
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State | OH
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Zip | 43783
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Country | US
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Telephone | 740-450-3294
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Fax | 740-450-3295
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Provider Business Mailing Address
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Address Line | 3777 JAMES CT
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City | ZANESVILLE
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State | OH
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Zip | 43701-8127
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Country | US
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Telephone | 740-450-3294
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Fax | 740-450-3295
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Authorized Official
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Title or Position | PRESIDENT
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Name | MARK W SCOTT
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Credential | DPM
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Telephone | 740-450-3294
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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 | 36003086
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License Number State | OH
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