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Organization
TRI-COUNTY FOOT AND ANKLE CENTER INC
Active
Organization
TRI-COUNTY FOOT AND ANKLE CENTER INC
Active
Other names
Timothy D. Kistler, DPM
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TIMOTHY D. KISTLER DPM (PRESIDENT)
(419) 435-3554
Entity
Organization
Contact information
Practice address
614 W LYTLE ST, FOSTORIA, OH 44830-3422
(419) 435-3554
Mailing address
614 W LYTLE ST, FOSTORIA, OH 44830-3422
(419) 435-3554
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
OH36003099
OH
332B00000X
Durable Medical Equipment & Medical Supplies
OH36003099
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000141026
ANTHEM BLUE CROSS BLUE SHIELD
OH
05
—
2092239
—
OH
01
—
272741141003
MEDICAL MUTUAL OF OHIO
OH
01
—
480026415
MEDICARE RR
OH
Enumeration date
06/27/2008
Last updated
12/03/2013
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