Provider Demographics
NPI:1679197131
Name:HUMRICK, HANS CARL (DPM)
Entity Type:Individual
Prefix:
First Name:HANS
Middle Name:CARL
Last Name:HUMRICK
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7397 JEFFERSON BLVD
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40219-6178
Mailing Address - Country:US
Mailing Address - Phone:502-968-2233
Mailing Address - Fax:502-968-2283
Practice Address - Street 1:2818 GRANT LINE RD
Practice Address - Street 2:
Practice Address - City:NEW ALBANY
Practice Address - State:IN
Practice Address - Zip Code:47150-2492
Practice Address - Country:US
Practice Address - Phone:812-725-7542
Practice Address - Fax:812-725-7543
Is Sole Proprietor?:No
Enumeration Date:2020-06-01
Last Update Date:2023-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY284787213E00000X, 213ES0103X
IN07001433A213ES0103X, 213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
No213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery