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General NPI Number Information
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NPI Number | 1639575012
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Entity Type | Organization
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Legal Business Name | OHIO PODIATRIC PHYSICIANS AND SURGEONS GROUP, LLC
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Dates
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Enumeration Date | 11/12/2014
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Last Update Date | 11/12/2014
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Provider Practice Location Address
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Address Line | 1725 WESTERN AVE SUITE C
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City | FINDLAY
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State | OH
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Zip | 45840-1345
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Country | US
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Telephone | 419-423-1888
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Fax |
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Provider Business Mailing Address
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Address Line | 1725 WESTERN AVE SUITE C
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City | FINDLAY
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State | OH
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Zip | 45840-1345
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Country | US
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Telephone | 419-423-1888
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Fax |
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Authorized Official
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Title or Position | PODIATRIST
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Name | DR. THOMAS F VAIL
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Credential | D.P.M.
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Telephone | 419-423-1888
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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 | OH2326
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 213ES0131X
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Taxonomy Name | Foot Surgery Podiatrist
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License Number | OH2326
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License Number State | OH
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Taxonomy #3
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Taxonomy Code | 213EP1101X
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Taxonomy Name | Primary Podiatric Medicine Podiatrist
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License Number | OH2326
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License Number State | OH
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