Provider Demographics
NPI:1932543048
Name:FOEGER, NICHOLAS CHRISTIAN (MD, PHD)
Entity Type:Individual
Prefix:
First Name:NICHOLAS
Middle Name:CHRISTIAN
Last Name:FOEGER
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4130 DUTCHMANS LN STE 300
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40207-4710
Mailing Address - Country:US
Mailing Address - Phone:502-897-1794
Mailing Address - Fax:502-897-3852
Practice Address - Street 1:4130 DUTCHMANS LN STE 300
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40207-4710
Practice Address - Country:US
Practice Address - Phone:502-897-1794
Practice Address - Fax:502-897-3852
Is Sole Proprietor?:No
Enumeration Date:2013-04-18
Last Update Date:2020-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY54004207XS0106X, 207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN01084343AOtherLICENSE
IN300041418Medicaid
KY7100669500Medicaid