Grand Lake Podiatry, Inc is a
Podiatrist - Foot & Ankle Surgery based in Minster, Ohio. Grand Lake Podiatry, Inc is licensed to practice in Ohio (license number 36 002772) and their current practice location is
6 Eagle Dr, Minster, Ohio. It can be reached at their office (for appointments etc.) via phone at
(419) 628-7874.
NPI number for Grand Lake Podiatry, Inc is 1164694428 and their current mailing address is 1222 Irmscher Blvd, Celina, Ohio. Grand Lake Podiatry, Inc
does not participate in medicare program and thus does not accept medicare assignments. The facility's NPI Number is 1164694428.
Healthcare Provider's Profile
| Full Name | Grand Lake Podiatry, Inc |
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| Type | Facility |
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| Speciality | Podiatrist - Foot & Ankle Surgery |
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| Location | 6 Eagle Dr, Minster, Ohio |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1164694428
- Provider Enumeration Date: 03/27/2008
- Last Update Date: 04/18/2008
Medical Identifiers
Medical identifiers for Grand Lake Podiatry, Inc such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1164694428 | NPI | - | NPPES |
| 2544876 | Medicaid | OH | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 213ES0103X | Podiatrist - Foot & Ankle Surgery | 36 002772 (Ohio) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Grand Lake Podiatry, Inc is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Grand Lake Podiatry, Inc
1222 Irmscher Blvd,
Celina, OH 45822-8305
Ph: (419) 586-7874 | Grand Lake Podiatry, Inc
6 Eagle Dr,
Minster, OH 45865-9714
Ph: (419) 628-7874 |
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