MEDICARE: LEONARD R. JANIS DPM

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	36001643	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	:	1700889334
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LEONARD R. JANIS DPM

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	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/27/2005
Last Update Date	:	11/03/2009

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