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General NPI Number Information
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NPI Number | 1932462645
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Entity Type | Individual
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Provider Name | MATTHEW RYAN FELTNER D.P.M.
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Gender | Male
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Dates
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Enumeration Date | 06/18/2012
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Last Update Date | 01/10/2017
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Provider Practice Location Address
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Address Line | 1698 OLD LEBANON RD STE 3A
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City | CAMPBELLSVILLE
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State | KY
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Zip | 42718-9662
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Country | US
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Telephone | 270-465-0632
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Fax |
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Provider Business Mailing Address
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Address Line | 274 SHREVEPORT DR
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City | CAMPBELLSVILLE
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State | KY
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Zip | 42718-9325
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Country | US
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Telephone | 270-403-1934
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 39
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License Number State | OH
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