Healthcare Provider Details

I. General information

NPI: 1497042808
Provider Name (Legal Business Name): KENTUCKIANA FOOT & ANKLE PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/06/2011
Last Update Date: 04/01/2025
Certification Date: 04/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2818 GRANT LINE RD
NEW ALBANY IN
47150-2492
US

IV. Provider business mailing address

4612 OUTER LOOP
LOUISVILLE KY
40219-3971
US

V. Phone/Fax

Practice location:
  • Phone: 812-725-7542
  • Fax: 812-725-7543
Mailing address:
  • Phone: 502-804-4811
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: DR. SYED A KHADER
Title or Position: OWNER
Credential: DPM
Phone: 812-725-7542