MEDICARE: DR. KIMBERLY RENEE FOUSHEE D.M.D.

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	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry	6443	KY

General Provider Information

NPI Number	:	1972517399
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KIMBERLY RENEE FOUSHEE D.M.D.

Provider Business Mailing Address
First Line	:	9127 FERN CREEK RD
Second Line	:
City	:	LOUISVILLE
State	:	KY
Zip	:	40291-2711
Country	:	US
Telephone Number	:	502-239-0013
Fax Number	:	502-239-0984

Provider Business Practice Location Address
First Line	:	9127 FERN CREEK RD
Second Line	:
City	:	LOUISVILLE
State	:	KY
Zip	:	40291-2711
Country	:	US
Telephone Number	:	502-239-0013
Fax Number	:	502-239-0984

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/28/2006
Last Update Date	:	07/08/2007

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