MEDICARE: TOTAL FOOT & ANKLE OF OHIO 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	213ES0103X	Foot & Ankle Surgery Podiatrist		OH

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

General Provider Information

NPI Number	:	1336124528
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TOTAL FOOT & ANKLE OF OHIO INC

Provider Business Mailing Address
First Line	:	3780 RIDGE MILL DR
Second Line	:
City	:	HILLIARD
State	:	OH
Zip	:	43026-7458
Country	:	US
Telephone Number	:	614-870-2029
Fax Number	:	614-870-1692

Provider Business Practice Location Address
First Line	:	3780 RIDGE MILL DR
Second Line	:
City	:	HILLIARD
State	:	OH
Zip	:	43026-7458
Country	:	US
Telephone Number	:	614-870-2029
Fax Number	:	614-870-1692

Authorized Official
Title or Position	:	PRESIDENT
Name	:	LEONARD R JANIS
Credential	:	DPM
Telephone Number	:	614-870-2029

Provider Enumeration Date	:	12/09/2005
Last Update Date	:	11/02/2010

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