Healthcare Provider Details

I. General information

NPI: 1851828594
Provider Name (Legal Business Name): MICHELLE A HURLESS DPM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MISS MICHELLE KLAUSING

II. Dates (important events)

Enumeration Date: 05/12/2017
Last Update Date: 09/17/2024
Certification Date: 09/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2700 OLD ROSEBUD RD STE 110
LEXINGTON KY
40509-8624
US

IV. Provider business mailing address

3684 STOLEN HORSE TRCE
LEXINGTON KY
40509-2144
US

V. Phone/Fax

Practice location:
  • Phone: 859-264-1141
  • Fax: 859-264-1963
Mailing address:
  • Phone: 419-615-3499
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberE6083
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: