| Northeastern Ohio Foot & Ankle Surgical Associates, Inc. | |
|
4403 Clover Dr, Ravenna, OH 44266-8636 | |
| (330) 687-7464 | |
| Not Available |
| Full Name | Northeastern Ohio Foot & Ankle Surgical Associates, Inc. |
|---|---|
| Type | Facility |
| Speciality | Podiatrist - Foot & Ankle Surgery |
| Location | 4403 Clover Dr, Ravenna, Ohio |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639235351 | NPI | - | NPPES |
| 2538178 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 213ES0103X | Podiatrist - Foot & Ankle Surgery | 36.003352 (Ohio) | Primary |
| Provider Name | Theodore A Buccilli |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1164413019 PECOS PAC ID: 5395798318 Enrollment ID: I20050301000973 |
| Mailing Address | Practice Location Address |
|---|---|
| Northeastern Ohio Foot & Ankle Surgical Associates, Inc. 4403 Clover Dr, Ravenna, OH 44266-8636 Ph: (330) 687-7464 | Northeastern Ohio Foot & Ankle Surgical Associates, Inc. 4403 Clover Dr, Ravenna, OH 44266-8636 Ph: (330) 687-7464 |
Eric J Paul, DPM Podiatrist Medicare: Accepting Medicare Assignments Practice Location: 6693 North Chestnut St, Ste 12-b, Ravenna, OH 44266 Phone: 330-297-1211 Fax: 330-297-6550 | |
Portage Foot Health, Inc. Podiatrist Medicare: Not Enrolled in Medicare Practice Location: 444 S Meridian St, Ste 7, Ravenna, OH 44266 Phone: 330-297-7330 Fax: 330-298-0497 | |
Ankle And Foot Care Centers Podiatrist Medicare: Not Enrolled in Medicare Practice Location: 444 S Meridian St Ste 7, Ravenna, OH 44266 Phone: 330-297-7330 Fax: 330-298-0497 | |
Dr. Theodore A Buccilli Jr., DPM Podiatrist Medicare: Medicare Enrolled Practice Location: 4403 Clover Dr, Ravenna, OH 44266 Phone: 330-687-7464 |