MEDICARE: PODIATRY OF HAMILTON, 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	213E00000X	Podiatrist

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
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1518098557
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PODIATRY OF HAMILTON, INC

Provider Business Mailing Address
First Line	:	7344 HAMILTON AVE
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45231-4322
Country	:	US
Telephone Number	:	513-729-4455
Fax Number	:	513-728-4739

Provider Business Practice Location Address
First Line	:	7344 HAMILTON AVE
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45231-4322
Country	:	US
Telephone Number	:	513-729-4455
Fax Number	:	513-728-4739

Authorized Official
Title or Position	:	PRESIDENT
Name	:	KRISTIN K TITKO
Credential	:	DPM
Telephone Number	:	513-729-4455

Provider Enumeration Date	:	03/09/2007
Last Update Date	:	02/28/2011

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