Provider Demographics
NPI:1578563458
Name:PINSKI, ANN K (DPM)
Entity Type:Individual
Prefix:
First Name:ANN
Middle Name:K
Last Name:PINSKI
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3901 DUTCHMANS LN
Mailing Address - Street 2:SUITE 103
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40207-4722
Mailing Address - Country:US
Mailing Address - Phone:502-741-4905
Mailing Address - Fax:502-409-4275
Practice Address - Street 1:3901 DUTCHMANS LN
Practice Address - Street 2:SUITE 103
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40207-4722
Practice Address - Country:US
Practice Address - Phone:502-741-4905
Practice Address - Fax:502-409-4275
Is Sole Proprietor?:No
Enumeration Date:2005-07-21
Last Update Date:2012-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY00179213E00000X, 213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
No213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY8000179500Medicaid
IN100382-900AMedicaid
T54198Medicare UPIN
KYK039091Medicare PIN