Healthcare Provider Details

I. General information

NPI: 1225307309
Provider Name (Legal Business Name): LOUISVILLE PODIATRY PSC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/20/2011
Last Update Date: 08/04/2025
Certification Date: 08/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2525 BARDSTOWN RD
LOUISVILLE KY
40205-2665
US

IV. Provider business mailing address

2525 BARDSTOWN RD
LOUISVILLE KY
40205-2665
US

V. Phone/Fax

Practice location:
  • Phone: 502-458-8989
  • Fax: 502-451-5439
Mailing address:
  • Phone: 502-458-8989
  • Fax: 502-451-5439

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number00176
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: LISA MERKOW
Title or Position: PRESIDENT
Credential:
Phone: 278-009-9587