Organization
SUPPAN FOOT AND ANKLE CLINIC INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JASON NORBERT SUPPAN DPM (PRESIDENT)
(330) 642-6070
Entity
Organization
Contact information
Practice address
1710 PARADISE RD, ORRVILLE, OH 44667-9418
(330) 682-6070
(330) 684-2822
Mailing address
1710 PARADISE RD, ORRVILLE, OH 44667-9418
(330) 682-6070
(330) 684-2822
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0512396
—
OH
01
—
1669428991
NPI
OH
Enumeration date
05/26/2006
Last updated
01/21/2026
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