Provider Demographics
NPI:1376800680
Name:COMPREHENSIVE FOOT & ANKLE CENTERS
Entity Type:Organization
Organization Name:COMPREHENSIVE FOOT & ANKLE CENTERS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:D.P.M./OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:
Authorized Official - Last Name:HUBBARD
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:502-797-3338
Mailing Address - Street 1:1905 W HEBRON LN
Mailing Address - Street 2:SUITE 204
Mailing Address - City:SHEPHERDSVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40165-7465
Mailing Address - Country:US
Mailing Address - Phone:502-797-3338
Mailing Address - Fax:502-957-1731
Practice Address - Street 1:1905 W HEBRON LN
Practice Address - Street 2:SUITE 204
Practice Address - City:SHEPHERDSVILLE
Practice Address - State:KY
Practice Address - Zip Code:40165-7465
Practice Address - Country:US
Practice Address - Phone:502-797-3338
Practice Address - Fax:502-957-1731
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-12
Last Update Date:2013-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY00287213ES0103X
332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KYK051350Medicare PIN