Individual
JASON NORBERT SUPPAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
1710 PARADISE RD, ORRVILLE, OH 44667-9418
(330) 682-6070
(330) 684-2822
Mailing address
6200 PLEASANT AVE STE 3, FAIRFIELD, OH 45014-4671
(330) 682-6070
(330) 684-2822
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
36-00-3017-S
OH
213ES0103X
Foot & Ankle Surgery Podiatrist
36-00-3017-S
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1528059391
NPI
OH
05
—
2012842
—
OH
Enumeration date
11/02/2005
Last updated
01/21/2026
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