Provider Demographics
NPI:1912196338
Name:OHIO FOOT INC
Entity type:Organization
Organization Name:OHIO FOOT INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:JOEL
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:CONSOLO
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:419-443-8637
Mailing Address - Street 1:672 MIAMI ST STE D
Mailing Address - Street 2:
Mailing Address - City:TIFFIN
Mailing Address - State:OH
Mailing Address - Zip Code:44883-1984
Mailing Address - Country:US
Mailing Address - Phone:419-443-8637
Mailing Address - Fax:419-443-9937
Practice Address - Street 1:672 MIAMI ST STE D
Practice Address - Street 2:
Practice Address - City:TIFFIN
Practice Address - State:OH
Practice Address - Zip Code:44883-1984
Practice Address - Country:US
Practice Address - Phone:419-443-8637
Practice Address - Fax:419-443-9937
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-22
Last Update Date:2024-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH36002994213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2240695Medicaid
OHU80949Medicare UPIN
OH2240695Medicaid