Provider Demographics
NPI:1427114446
Name:ASSOCIATES IN PODIATRY, INC.
Entity type:Organization
Organization Name:ASSOCIATES IN PODIATRY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:A
Authorized Official - Last Name:YOUNG
Authorized Official - Suffix:JR
Authorized Official - Credentials:BS
Authorized Official - Phone:937-399-8011
Mailing Address - Street 1:415 W HARDING RD
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:45504-1706
Mailing Address - Country:US
Mailing Address - Phone:937-399-8011
Mailing Address - Fax:937-399-7096
Practice Address - Street 1:415 W HARDING RD
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:OH
Practice Address - Zip Code:45504-1706
Practice Address - Country:US
Practice Address - Phone:937-399-8011
Practice Address - Fax:937-399-7096
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-28
Last Update Date:2007-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH9301881Medicare PIN
OH0144040001Medicare NSC