MEDICARE: OHIO FOOT & ANKLE, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207XX0004X	Orthopaedic Foot and Ankle Surgery Physician

General Provider Information

NPI Number	:	1023742608
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OHIO FOOT & ANKLE, INC.

Provider Business Mailing Address
First Line	:	350 W WILSON BRIDGE RD STE 200
Second Line	:
City	:	WORTHINGTON
State	:	OH
Zip	:	43085-2591
Country	:	US
Telephone Number	:	614-505-8990
Fax Number	:	614-895-8810

Provider Business Practice Location Address
First Line	:	3695 N HIGH ST
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43214-3520
Country	:	US
Telephone Number	:	614-267-8387
Fax Number	:	614-267-2250

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	CHRIS MASCIOLA
Credential	:
Telephone Number	:	614-895-8747

Provider Enumeration Date	:	07/11/2022
Last Update Date	:	07/11/2022

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