MEDICARE: ROBERT G. MCHENDRIX, D.P.M.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	335E00000X	Prosthetic/Orthotic Supplier	K0125	KY
2	332B00000X	Durable Medical Equipment & Medical Supplies	K0125	KY

General Provider Information

NPI Number	:	1831360981
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ROBERT G. MCHENDRIX, D.P.M.

Provider Business Mailing Address
First Line	:	3126 DIXIE HWY
Second Line	:
City	:	ERLANGER
State	:	KY
Zip	:	41018-1866
Country	:	US
Telephone Number	:	859-331-4777
Fax Number	:

Provider Business Practice Location Address
First Line	:	3126 DIXIE HWY
Second Line	:
City	:	ERLANGER
State	:	KY
Zip	:	41018-1866
Country	:	US
Telephone Number	:	859-331-4777
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. ROBERT G MCHENDRIX III
Credential	:	DPM
Telephone Number	:	859-331-4777

Provider Enumeration Date	:	03/17/2008
Last Update Date	:	03/17/2008

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