MEDICARE: DR. JEFFREY VINCENT CHOU D.P.M.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	213E00000X	Podiatrist	00193	KY
2	332B00000X	Durable Medical Equipment & Medical Supplies		KY
3	213ES0103X	Foot & Ankle Surgery Podiatrist	00193	KY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	1184623290	OTHER	KY	NPI
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1184623290
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JEFFREY VINCENT CHOU D.P.M.

Provider Business Mailing Address
First Line	:	PO BOX 43102
Second Line	:
City	:	LOUISVILLE
State	:	KY
Zip	:	40253-0102
Country	:	US
Telephone Number	:	270-433-5806
Fax Number	:	270-433-2443

Provider Business Practice Location Address
First Line	:	117 S HUBBARDS LN
Second Line	:	SUITE 102
City	:	LOUISVILLE
State	:	KY
Zip	:	40207-3937
Country	:	US
Telephone Number	:	502-895-3840
Fax Number	:	502-897-3642

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/20/2005
Last Update Date	:	04/02/2019

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Directions to “ DR. JEFFREY VINCENT CHOU D.P.M.” Practice Location

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