Healthcare Provider Details

I. General information

NPI: 1104804384
Provider Name (Legal Business Name): MARTIN JOSEPH SETTER D.P.M.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/06/2006
Last Update Date: 10/24/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

289 IRELAND AVE
FORT KNOX KY
40121-5111
US

IV. Provider business mailing address

289 IRELAND AVE
FORT KNOX KY
40121-5111
US

V. Phone/Fax

Practice location:
  • Phone: 502-624-9575
  • Fax:
Mailing address:
  • Phone: 502-624-9575
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number600
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: