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General NPI Number Information
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NPI Number | 1881799294
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Entity Type | Organization
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Legal Business Name | FOOT AND ANKLE CENTERS OF OHIO, INC.
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Dates
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Enumeration Date | 09/13/2006
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Last Update Date | 03/23/2015
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Provider Practice Location Address
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Address Line | 825 W MARKET ST SUITE 305
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City | LIMA
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State | OH
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Zip | 45805-2790
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Country | US
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Telephone | 419-224-8414
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Fax | 419-224-8436
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Provider Business Mailing Address
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Address Line | 1013 E SPRING ST
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City | SAINT MARYS
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State | OH
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Zip | 45885-2447
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Country | US
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Telephone | 419-394-8664
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Fax | 419-394-1148
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. EUGENE R LITTLE JR.
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Credential | D.P.M.
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Telephone | 419-394-8664
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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 | 36002287L
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License Number State | OH
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