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General NPI Number Information
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NPI Number | 1154691301
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Entity Type | Organization
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Legal Business Name | LOUISVILLE PODIATRY PSC
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Dates
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Enumeration Date | 01/05/2012
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Last Update Date | 01/31/2013
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Provider Practice Location Address
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Address Line | 2525 BARDSTOWN RD
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City | LOUISVILLE
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State | KY
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Zip | 40205-2665
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Country | US
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Telephone | 502-458-8989
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Fax | 502-451-5439
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Provider Business Mailing Address
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Address Line | 2525 BARDSTOWN RD
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City | LOUISVILLE
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State | KY
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Zip | 40205-2665
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Country | US
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Telephone | 502-458-8989
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Fax | 502-451-5439
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Authorized Official
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Title or Position | PRESIDENT
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Name | ALAN K MAUSER
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Credential | DPM
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Telephone | 502-458-8989
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 00176
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License Number State | KY
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