MEDICARE: HOME VISIT PODIATRISTS, 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	213EP1101X	Primary Podiatric Medicine Podiatrist

General Provider Information

NPI Number	:	1841433703
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOME VISIT PODIATRISTS, INC.

Provider Business Mailing Address
First Line	:	2010 WAYLAND AVE
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45212-3708
Country	:	US
Telephone Number	:	513-631-6016
Fax Number	:	513-631-2166

Provider Business Practice Location Address
First Line	:	2010 WAYLAND AVE
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45212-3708
Country	:	US
Telephone Number	:	513-631-6016
Fax Number	:	513-631-2166

Authorized Official
Title or Position	:	PHYSICIAN/OWNER
Name	:	DR. SAMUEL LIEBSON
Credential	:	D.P.M.
Telephone Number	:	513-631-6016

Provider Enumeration Date	:	04/08/2009
Last Update Date	:	08/04/2009

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