SOUTH CENTRAL KENTUCKY FOOT & ANKLE CENTER NPI 1063675866

NPI Information

NPI: 1063675866
Provider Name: SOUTH CENTRAL KENTUCKY FOOT & ANKLE CENTER
Classification: Podiatrist - 213ES0103X
Entity Type: Organization

Specialization: Foot & Ankle Surgery

CLIA Number: 18D2289781

Address:
843 FAIRVEW AVENUE
SUITE B5
BOWLING GREEN, KY
ZIP 42101
Phone: (270) 846-1900
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SOUTH CENTRAL KENTUCKY FOOT & ANKLE CENTER is a foot and ankle surgery podiatrist in Bowling Green, KY. SOUTH CENTRAL KENTUCKY FOOT & ANKLE CENTER NPI is 1063675866. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

843 FAIRVEW AVENUE
SUITE B5
BOWLING GREEN, KY
ZIP 42101-914
Phone: (270) 846-1900
Fax: (270) 846-2919

The provider's authorized official is Christopher M Holland .
The authorized official title is Owner and has the following contact phone number (270) 846-1900.

The CLIA number assigned to this NPI record is 18D2289781 - health fair with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/2/2008 and was last updated on 11/5/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	213ES0103X	Podiatrist	Foot & Ankle Surgery	234	KENTUCKY	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	90013897	OTHER	KENTUCKY	KY HEALTH CHOICES- DME

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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