Individual
DR. MATTHEW JAMES CONNOLLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.P.M.
Contact information
Practice address
560 S LOOP RD, EDGEWOOD, KY 41017-3405
(859) 301-2663
(859) 817-7848
Mailing address
560 S LOOP RD, EDGEWOOD, KY 41017-3405
(859) 301-2663
(859) 301-0655
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
244122
KY
213EP1101X
Primary Podiatric Medicine Podiatrist
00180
KY
213EP1101X
Primary Podiatric Medicine Podiatrist
244122
KY
213ES0103X
Foot & Ankle Surgery Podiatrist
00180
KY
213ES0103X
Foot & Ankle Surgery Podiatrist
244122
KY
Other
Enumeration date
06/01/2005
Last updated
07/07/2021
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