DR. Theodore A Buccilli JR., DPM

NPI #1164413019 in Ravenna, Ohio

Provider Information

NPI Number: 1164413019
Entity Type: Individual
Name: DR. Theodore A Buccilli JR., DPM
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Podiatrist
Credential: DPM
Enumeration Date: Oct 31, 2005
Last Updated: Aug 15, 2025

Practice Location

Address: 4403 CLOVER DR
City: Ravenna
State: Ohio
ZIP Code: 44266-8636
Phone: (330) 687-7464

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Podiatrist	213E00000X	Primary

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Organizations

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