Basic Information
| Provider Information | |||||||||
| NPI: | 1447270897 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | TRI-COUNTY FOOT & ANKLE ASSOCIATES, INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3777 JAMES CT | ||||||||
| Address2: | |||||||||
| City: | ZANESVILLE | ||||||||
| State: | OH | ||||||||
| PostalCode: | 437018127 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7404503294 | ||||||||
| FaxNumber: | 7404503295 | ||||||||
| Practice Location | |||||||||
| Address1: | 3777 JAMES CT | ||||||||
| Address2: | |||||||||
| City: | ZANESVILLE | ||||||||
| State: | OH | ||||||||
| PostalCode: | 437018127 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7404503294 | ||||||||
| FaxNumber: | 7404503295 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/20/2006 | ||||||||
| LastUpdateDate: | 07/21/2008 | ||||||||
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| AuthorizedOfficialLastName: | SCOTT | ||||||||
| AuthorizedOfficialFirstName: | MARK | ||||||||
| AuthorizedOfficialMiddleName: | WAYNE | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 7404503294 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | DPM | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 213ES0103X | 36003086 | OH | Y | 193400000X SINGLE SPECIALTY GROUP | Podiatric Medicine & Surgery Service Providers | Podiatrist | Foot & Ankle Surgery |
No ID Information.