Healthcare Provider Details

I. General information

NPI: 1376800680
Provider Name (Legal Business Name): COMPREHENSIVE FOOT & ANKLE CENTERS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/12/2012
Last Update Date: 05/23/2025
Certification Date: 05/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1905 W HEBRON LN SUITE 204
SHEPHERDSVILLE KY
40165-7465
US

IV. Provider business mailing address

PO BOX 825159
PHILADELPHIA PA
19182-5159
US

V. Phone/Fax

Practice location:
  • Phone: 502-797-3338
  • Fax: 502-919-7710
Mailing address:
  • Phone: 502-797-3338
  • Fax: 502-957-1731

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: CHRISTOPHER HUBBARD
Title or Position: D.P.M./OWNER
Credential: D.P.M.
Phone: 502-797-3338