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General NPI Number Information
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NPI Number | 1780472373
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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 | 04/25/2025
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Last Update Date | 04/25/2025
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Provider Practice Location Address
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Address Line | 1938 LYDA AVE
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City | BOWLING GREEN
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State | KY
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Zip | 42104-3326
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Country | US
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Telephone | 270-796-6160
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Fax |
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Provider Business Mailing Address
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Address Line | 6801 DIXIE HWY STE 134
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City | LOUISVILLE
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State | KY
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Zip | 40258-3952
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Country | US
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Telephone | 502-805-3338
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | SYED ABDUL KHADER
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Credential |
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Telephone | 502-533-9071
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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 |
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License Number State |
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