Healthcare Provider Details

I. General information

NPI: 1528011418
Provider Name (Legal Business Name): FIRST CHOICE ANKLE & FOOT CARE CENTER, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/19/2006
Last Update Date: 04/15/2021
Certification Date: 04/15/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1701 MIDLAND TRL
SHELBYVILLE KY
40065-1711
US

IV. Provider business mailing address

1701 MIDLAND TRL
SHELBYVILLE KY
40065-1711
US

V. Phone/Fax

Practice location:
  • Phone: 502-633-3338
  • Fax: 502-633-2704
Mailing address:
  • Phone: 502-633-3338
  • Fax: 502-633-2704

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number00286
License Number StateKY
# 2
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number00286
License Number StateKY

VIII. Authorized Official

Name: HEIKO B ADAMS
Title or Position: OWNER
Credential: DPM
Phone: 502-633-3338