Organization
HUDSON FOOT CLINIC, INC.
Active
Other names
Western Reserve Foot Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KENNETH HARLEY NIXON D.P.M. (PRESIDENT)
(330) 689-3338
Entity
Organization
Contact information
Practice address
4495 DARROW RD, STOW, OH 44224-1854
(330) 689-3338
(330) 689-0282
Mailing address
4495 DARROW RD, STOW, OH 44224-1854
(330) 689-3338
(330) 689-0282
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
36-00-2719
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2915742
—
OH
01
—
480016282
MEDICARE RAILROAD
OH
Enumeration date
04/16/2007
Last updated
04/23/2009
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