# BLUEGRASS REGIONAL FOOT & ANKLE ASSOCIATES

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1780837062
- **Authorized official:** DR. PAUL K KRESTIK DPM (PHYSICIAN/OWNER)
- **Authorized official phone:** (606) 862-9900

## Contact information

- **Practice address:** 1105 W 5TH ST, \#3, LONDON, KY 40741-1610
- **Practice address phone:** (606) 862-9900
- **Practice address fax:** (606) 862-8901
- **Mailing address:** 1105 W 5TH ST, \#3, LONDON, KY 40741-1610
- **Mailing address phone:** (606) 862-9900
- **Mailing address fax:** (606) 862-8901

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363L00000X | Nurse Practitioner | 5140P | KY | Yes |

## Other

- **Enumeration date:** 10/30/2008
- **Last updated:** 10/30/2008