Healthcare Provider Details

I. General information

NPI: 1831360981
Provider Name (Legal Business Name): ROBERT G. MCHENDRIX, D.P.M.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/17/2008
Last Update Date: 03/17/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3126 DIXIE HWY
ERLANGER KY
41018-1866
US

IV. Provider business mailing address

3126 DIXIE HWY
ERLANGER KY
41018-1866
US

V. Phone/Fax

Practice location:
  • Phone: 859-331-4777
  • Fax:
Mailing address:
  • Phone: 859-331-4777
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License NumberK0125
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License NumberK0125
License Number StateKY

VIII. Authorized Official

Name: DR. ROBERT G MCHENDRIX III
Title or Position: OWNER
Credential: DPM
Phone: 859-331-4777