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Organization
BLUEGRASS FOOT AND ANKLE CARE, PLLC
Active
Organization
BLUEGRASS FOOT AND ANKLE CARE, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RANDALL W. HALL D.P.M. (BUSINESS OWNER)
(859) 623-3550
Entity
Organization
Contact information
Practice address
326 HIGHLAND PARK DR, RICHMOND, KY 40475-3487
(859) 623-3550
Mailing address
326 HIGHLAND PARK DR, RICHMOND, KY 40475-3487
(859) 623-3550
(859) 623-3393
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
00274
KY
332B00000X
Durable Medical Equipment & Medical Supplies
00274
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000330835
ANTHEM
KY
05
—
7100051420
—
KY
05
—
90011214
—
KY
Enumeration date
03/07/2007
Last updated
09/20/2019
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