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Organization
DR. MARK J. EDMUNDS, DPM, P.L.L.C.
Active
Organization
DR. MARK J. EDMUNDS, DPM, P.L.L.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK J. EDMUNDS DPM (DIRECTOR OWNER)
(270) 885-1203
Entity
Organization
Contact information
Practice address
1610 S MAIN ST, SUITE 9, HOPKINSVILLE, KY 42240-1974
(270) 885-1203
(270) 885-1561
Mailing address
1610 S MAIN ST, SUITE 9, HOPKINSVILLE, KY 42240-1974
(270) 885-1203
(270) 885-1561
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
00294
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8000049000
—
KY
01
—
DD3588
RAILROAD MEDICARE
—
Enumeration date
01/27/2006
Last updated
08/20/2008
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