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Organization
NORTHERN KENTUCKY FOOT SPECIALISTS, PSC
Active
Organization
NORTHERN KENTUCKY FOOT SPECIALISTS, PSC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM M NIELSON DPM (PRESIDENT)
(859) 746-7461
Entity
Organization
Contact information
Practice address
525 ALEXANDRIA PIKE, SUITE 230, SOUTHGATE, KY 41071-3290
(859) 441-4334
(859) 441-3698
Mailing address
PO BOX 389, BURLINGTON, KY 41005-0389
(859) 746-7461
(859) 746-7464
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
80903792
—
KY
05
—
90260191
—
KY
01
—
C11409
RR MEDICARE
KY
Enumeration date
10/20/2006
Last updated
02/12/2010
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