Healthcare Provider Details

I. General information

NPI: 1366619074
Provider Name (Legal Business Name): AMY S FOLLMER D.P.M.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/12/2008
Last Update Date: 08/06/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

151 N EAGLE CREEK DR STE 201
LEXINGTON KY
40509-1889
US

IV. Provider business mailing address

151 N EAGLE CREEK DR STE 201
LEXINGTON KY
40509-1889
US

V. Phone/Fax

Practice location:
  • Phone: 859-543-2500
  • Fax: 859-543-9680
Mailing address:
  • Phone: 859-543-2500
  • Fax: 859-543-9680

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number259
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: