# SUPPAN FOOT AND ANKLE CLINIC INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1669428991
- **Authorized official:** JASON NORBERT SUPPAN DPM (PRESIDENT)
- **Authorized official phone:** (330) 642-6070

## Contact information

- **Practice address:** 1710 PARADISE RD, ORRVILLE, OH 44667-9418
- **Practice address phone:** (330) 682-6070
- **Practice address fax:** (330) 684-2822
- **Mailing address:** 1710 PARADISE RD, ORRVILLE, OH 44667-9418
- **Mailing address phone:** (330) 682-6070
- **Mailing address fax:** (330) 684-2822

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 213ES0103X | Foot & Ankle Surgery Podiatrist | — | NULL | Yes |
| 213ES0103X | Foot & Ankle Surgery Podiatrist | — | — | Yes |

## Other

- **Enumeration date:** 05/26/2006
- **Last updated:** 01/21/2026

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 0512396 | — | OH |
| 01 | — | 1669428991 | NPI | OH |