Organization
WILLIAM D TENNEY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WILLIAM D. TENNEY D.P.M. (OWNER)
(440) 974-3338
Entity
Organization
Contact information
Practice address
8899 MENTOR AVE, MENTOR, OH 44060-6211
(440) 974-3338
Mailing address
8899 MENTOR AVE, MENTOR, OH 44060-6211
(440) 974-3338
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
36001599
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0232948
—
OH
01
—
274388804003
MEDICAL MUTUAL OF OHIO
OH
01
—
480031264B
RR MEDICARE
OH
Enumeration date
09/24/2006
Last updated
11/10/2011
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