Provider Demographics
NPI:1881600617
Name:PODIATRIC HEALTH PHYSICIANS INC
Entity type:Organization
Organization Name:PODIATRIC HEALTH PHYSICIANS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:A
Authorized Official - Last Name:RANSOM
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:330-364-7546
Mailing Address - Street 1:365 RIFFEL RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:WOOSTER
Mailing Address - State:OH
Mailing Address - Zip Code:44691-8592
Mailing Address - Country:US
Mailing Address - Phone:330-364-7546
Mailing Address - Fax:330-364-3720
Practice Address - Street 1:365 RIFFEL RD
Practice Address - Street 2:SUITE A
Practice Address - City:WOOSTER
Practice Address - State:OH
Practice Address - Zip Code:44691-8592
Practice Address - Country:US
Practice Address - Phone:330-364-7546
Practice Address - Fax:330-364-3720
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-01
Last Update Date:2011-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1623213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0978938Medicaid
OH0978938Medicaid
OH4331320001Medicare NSC