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General NPI Number Information
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NPI Number | 1174718548
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Entity Type | Organization
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Legal Business Name | FRANKFORT FOOT CLINIC, PLLC
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Dates
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Enumeration Date | 09/10/2007
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Last Update Date | 07/16/2008
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Provider Practice Location Address
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Address Line | 5 PHYSICIANS PARK STE 3
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City | FRANKFORT
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State | KY
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Zip | 40601-4163
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Country | US
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Telephone | 502-227-7569
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Fax | 502-227-4442
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Provider Business Mailing Address
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Address Line | 5 PHYSICIANS PARK STE 3
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City | FRANKFORT
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State | KY
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Zip | 40601-4163
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Country | US
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Telephone | 502-227-7569
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Fax | 502-227-4442
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Authorized Official
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Title or Position | OWNER
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Name | JOHN W FRICKER JR.
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Credential | DPM
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Telephone | 502-227-7569
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | 00246
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License Number State | KY
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