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General NPI Number Information
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NPI Number | 1699906552
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Entity Type | Organization
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Legal Business Name | EAST END FOOT & ANKLE, PSC
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Dates
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Enumeration Date | 07/27/2009
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Last Update Date | 01/16/2019
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Provider Practice Location Address
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Address Line | 13105 EASTPOINT PARK BLVD
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City | LOUISVILLE
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State | KY
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Zip | 40223-4164
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Country | US
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Telephone | 502-426-4228
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Fax | 502-426-4420
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Provider Business Mailing Address
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Address Line | 13105 EASTPOINT PARK BLVD
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City | LOUISVILLE
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State | KY
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Zip | 40223-4164
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Country | US
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Telephone | 502-426-4228
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Fax | 502-426-4420
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Authorized Official
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Title or Position | PRESIDENT
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Name | ADAM DIDYK
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Credential | DPM
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Telephone | 502-426-4228
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | 348
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License Number State | KY
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