MEDICARE: FOOT AND ANKLE SPECIALISTS OF CENTRAL OHIO 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	213E00000X	Podiatrist

General Provider Information

NPI Number	:	1689246548
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FOOT AND ANKLE SPECIALISTS OF CENTRAL OHIO LLC

Provider Business Mailing Address
First Line	:	426 BEECHER RD STE A
Second Line	:
City	:	GAHANNA
State	:	OH
Zip	:	43230-3506
Country	:	US
Telephone Number	:	740-344-8286
Fax Number	:

Provider Business Practice Location Address
First Line	:	2405 N COLUMBUS ST STE 110
Second Line	:
City	:	LANCASTER
State	:	OH
Zip	:	43130-8189
Country	:	US
Telephone Number	:	740-689-8085
Fax Number	:

Authorized Official
Title or Position	:	PRACTICE MANAGER
Name	:	COLLEEN RENEE GRIFFITH
Credential	:
Telephone Number	:	740-344-8286

Provider Enumeration Date	:	07/12/2021
Last Update Date	:	07/12/2021

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