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General NPI Number Information
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NPI Number | 1740509025
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Entity Type | Organization
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Legal Business Name | FOOT AND ANKLE CARE, PSC
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Dates
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Enumeration Date | 05/25/2010
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Last Update Date | 01/23/2024
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Provider Practice Location Address
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Address Line | 6407 PRESTON HWY SUITE #1
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City | LOUISVILLE
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State | KY
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Zip | 40219-1850
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Country | US
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Telephone | 502-409-5580
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Fax | 502-409-5582
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Provider Business Mailing Address
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Address Line | 6407 PRESTON HWY SUITE #1
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City | LOUISVILLE
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State | KY
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Zip | 40219-1850
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Country | US
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Telephone | 502-409-5580
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Fax | 502-409-5582
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JUDY NONGLAK OUTSA
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Credential | DPM
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Telephone | 502-409-5580
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | 00291
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License Number State | KY
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