Basic Information
| Provider Information | |||||||||
| NPI: | 1952879363 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ORTHOPAEDIC INSTITUTE OF OHIO, INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 801 MEDICAL DR STE A | ||||||||
| Address2: | |||||||||
| City: | LIMA | ||||||||
| State: | OH | ||||||||
| PostalCode: | 458044030 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4192226622 | ||||||||
| FaxNumber: | 4192240015 | ||||||||
| Practice Location | |||||||||
| Address1: | 27 ST LAWRENCE DR STE 102 | ||||||||
| Address2: | |||||||||
| City: | TIFFIN | ||||||||
| State: | OH | ||||||||
| PostalCode: | 448838313 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4194487424 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 11/05/2018 | ||||||||
| LastUpdateDate: | 11/05/2018 | ||||||||
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| AuthorizedOfficialLastName: | ACKERMAN | ||||||||
| AuthorizedOfficialFirstName: | KATHLYNN | ||||||||
| AuthorizedOfficialMiddleName: | L | ||||||||
| AuthorizedOfficialTitleorPosition: | ADMINISTRATOR | ||||||||
| AuthorizedOfficialTelephone: | 4192226622 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 213E00000X | N | 193200000X MULTI-SPECIALTY GROUP | Podiatric Medicine & Surgery Service Providers | Podiatrist | 207X00000X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Orthopaedic Surgery |
No ID Information.