Provider Demographics
NPI:1396535191
Name:PODIATRIC ASSOCIATES OF NORTHWEST OHIO, LLC
Entity type:Organization
Organization Name:PODIATRIC ASSOCIATES OF NORTHWEST OHIO, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:MIKE
Authorized Official - Middle Name:
Authorized Official - Last Name:LEACH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-286-5043
Mailing Address - Street 1:609 FORD ST
Mailing Address - Street 2:
Mailing Address - City:MAUMEE
Mailing Address - State:OH
Mailing Address - Zip Code:43537-1947
Mailing Address - Country:US
Mailing Address - Phone:419-893-5539
Mailing Address - Fax:419-893-6853
Practice Address - Street 1:1414 S BYRNE RD
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43614-2363
Practice Address - Country:US
Practice Address - Phone:419-893-5539
Practice Address - Fax:419-893-6853
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-07
Last Update Date:2025-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty