Ohio Podiatric Physicians and Surgeons Group, LLC
Organization Active NPI Primary Podiatric Medicine Podiatrist · Colimbiana, OH
NPI 1194121285 · NPPES record last updated Nov 17, 2014
Key facts
- NPI
- 1194121285
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Primary Podiatric Medicine Podiatrist 213EP1101X
- Legal business name
- OHIO PODIATRIC PHYSICIANS AND SURGEONS GROUP, LLC
- Practice address
- 258 State Route 14
Suite 1B
Colimbiana, OH 44408 - Phone
- (330) 482-1960
- Fax
- (330) 482-3590
- NPI assigned
- Nov 17, 2014
- Organization subpart
- No
Authorized official
- Name
- Lawrence Didomenico, DPM
- Title
- Managing Partner
- Phone
- (330) 629-8800
Corporate family (same tax ID) 39
National Provider Directory
- Tax ID family
- Ohio Podiatric Physicians and Surgeons Group LLC
Locations
258 E State Route 14
Ste 1B
Columbiana, OH 44408
Phone (330) 482-1960
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Primary Podiatric Medicine Podiatrist |
213EP1101X | Yes | ||
| Foot & Ankle Surgery Podiatrist |
213ES0103X | |||
| Foot Surgery Podiatrist |
213ES0131X |
Addresses
Primary practice location
258 State Route 14
Suite 1B
Colimbiana, OH 44408
Mailing address
8175 Market St
Youngstown, OH 44512-6244
Phone (330) 629-8800
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 17, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.