Provider Demographics
NPI:1629286257
Name:DIDYK, ADAM ALEXANDER (DPM)
Entity Type:Individual
Prefix:DR
First Name:ADAM
Middle Name:ALEXANDER
Last Name:DIDYK
Suffix:
Gender:M
Credentials:DPM
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Other - Credentials:
Mailing Address - Street 1:13105 EASTPOINT PARK BLVD
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40223
Mailing Address - Country:US
Mailing Address - Phone:502-426-4228
Mailing Address - Fax:502-426-4420
Practice Address - Street 1:13105 EASTPOINT PARK BLVD
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40223
Practice Address - Country:US
Practice Address - Phone:502-426-4228
Practice Address - Fax:502-426-4420
Is Sole Proprietor?:No
Enumeration Date:2007-05-18
Last Update Date:2017-12-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KY350213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery