Provider Demographics
NPI:1538200407
Name:ADVANCED FOOT SURGEONS, INC.
Entity type:Organization
Organization Name:ADVANCED FOOT SURGEONS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHUSSLER
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:937-392-0200
Mailing Address - Street 1:PO BOX 4937
Mailing Address - Street 2:
Mailing Address - City:BELFAST
Mailing Address - State:ME
Mailing Address - Zip Code:04915-4900
Mailing Address - Country:US
Mailing Address - Phone:937-392-0200
Mailing Address - Fax:937-392-9235
Practice Address - Street 1:114 MAIN STREET
Practice Address - Street 2:
Practice Address - City:RIPLEY
Practice Address - State:OH
Practice Address - Zip Code:45167-1232
Practice Address - Country:US
Practice Address - Phone:937-392-0200
Practice Address - Fax:937-392-9235
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:JEFFREY SCHUSSLER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-02-12
Last Update Date:2012-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH36002251213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0627718Medicaid
OH0542060001Medicare NSC
OHT80750Medicare UPIN