MEDICARE: OHIO FOOT AND ANKLE CENTER, LLC

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	213ES0103X	Foot & Ankle Surgery Podiatrist	36-00-3273	OH

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	DC4214	OTHER	OH	MEDICARE RR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1225041916
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OHIO FOOT AND ANKLE CENTER, LLC

Provider Business Mailing Address
First Line	:	3226 KENT RD
Second Line	:
City	:	STOW
State	:	OH
Zip	:	44224-4424
Country	:	US
Telephone Number	:	330-929-3331
Fax Number	:	330-929-5408

Provider Business Practice Location Address
First Line	:	1652 SOUTH UNION AVE
Second Line	:
City	:	ALLIANCE
State	:	OH
Zip	:	44601
Country	:	US
Telephone Number	:	330-823-2150
Fax Number	:	330-823-8933

Authorized Official
Title or Position	:	PRESIDENT
Name	:	AARON J CHOKAN
Credential	:	DPM
Telephone Number	:	330-823-2150

Provider Enumeration Date	:	08/14/2006
Last Update Date	:	11/15/2010

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Directions to “OHIO FOOT AND ANKLE CENTER, LLC ” Practice Location

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