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General NPI Number Information
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NPI Number | 1912196338
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Entity Type | Organization
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Legal Business Name | OHIO FOOT INC
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Dates
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Enumeration Date | 10/22/2007
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Last Update Date | 03/21/2024
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Provider Practice Location Address
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Address Line | 672 MIAMI ST STE D
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City | TIFFIN
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State | OH
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Zip | 44883-1984
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Country | US
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Telephone | 419-443-8637
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Fax | 419-443-9937
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Provider Business Mailing Address
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Address Line | 672 MIAMI ST STE D
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City | TIFFIN
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State | OH
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Zip | 44883-1984
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Country | US
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Telephone | 419-443-8637
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Fax | 419-443-9937
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Authorized Official
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Title or Position | PRESIDENT/PHYSICIAN
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Name | DR. JOEL WILLIAM CONSOLO
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Credential | D.P.M.
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Telephone | 419-443-8637
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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 | 36002994
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License Number State | OH
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