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General NPI Number Information
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NPI Number | 1982689949
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Entity Type | Individual
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Provider Name | BRIAN PRZYSTAWSKI DPM, PSC
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Gender | Male
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Dates
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Enumeration Date | 12/13/2005
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Last Update Date | 10/15/2024
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Provider Practice Location Address
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Address Line | 4119 BROWNS LN BLDG 2
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City | LOUISVILLE
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State | KY
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Zip | 40220-1500
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Country | US
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Telephone | 502-454-4187
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Fax | 502-454-4235
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Provider Business Mailing Address
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Address Line | PO BOX 909
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City | LOUISVILLE
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State | KY
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Zip | 40201-0909
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Country | US
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Telephone | 502-588-0328
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Fax | 502-454-4235
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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 | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | 07000635
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License Number State | IN
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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 | 195
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License Number State | KY
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