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General NPI Number Information
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NPI Number | 1114177979
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Entity Type | Organization
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Legal Business Name | KENTUCKIANA FOOT & ANKLE PLLC
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Dates
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Enumeration Date | 09/29/2008
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Last Update Date | 11/13/2025
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Provider Practice Location Address
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Address Line | 7397 JEFFERSON BLVD
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City | LOUISVILLE
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State | KY
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Zip | 40219-6178
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Country | US
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Telephone | 502-805-3338
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Fax | 502-805-7149
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Provider Business Mailing Address
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Address Line | 7397 JEFFERSON BLVD
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City | LOUISVILLE
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State | KY
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Zip | 40219-6178
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Country | US
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Telephone | 614-446-8175
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Fax | 614-665-7624
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Authorized Official
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Title or Position | OWNER PHYSICIAN
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Name | SYED A KHADER
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Credential | DPM
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Telephone | 502-968-2233
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number |
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Taxonomy #3
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Taxonomy Code | 261QM1200X
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Taxonomy Name | Magnetic Resonance Imaging (MRI) Clinic/Center
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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Taxonomy #5
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Taxonomy Code | 207RI0200X
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Taxonomy Name | Infectious Disease Physician
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number |
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License Number State |
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