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FAIRLAWN FOOT & ANKLE CLINIC INC NPI 1619189560


NPI Information

NPI: 1619189560
Provider Name: FAIRLAWN FOOT & ANKLE CLINIC INC
Classification: Podiatrist - 213E00000X
Entity Type: Organization
Address:
2640 W MARKET ST
SUITE 301
FAIRLAWN, OH
ZIP 44333
Phone: (330) 864-8501
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FAIRLAWN FOOT & ANKLE CLINIC INC is a podiatrist in Fairlawn, OH. The provider is a podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical and other operative procedures, prescribe corrective devices and prescribe and administer drugs and physical therapy. FAIRLAWN FOOT & ANKLE CLINIC INC NPI is 1619189560. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

2640 W MARKET ST
SUITE 301
FAIRLAWN, OH
ZIP 44333-202
Phone: (330) 864-8501

The provider's authorized official is Karen S Kellogg .
The authorized official title is Proprietor and has the following contact phone number (330) 836-6670.

The enumeration date for this NPI number is 5/4/2007 and was last updated on 3/10/2014.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1213E00000XPodiatrist36-00-3216-KOHIOYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
12884937MEDICAIDOHIO
24796730001MEDICARE NSCOHIO
3U89018MEDICARE UPINOHIO
49327051MEDICARE ID-TYPE UNSPECIFIEDOHIO

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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