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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
1125 BOONE AIRE RD, FLORENCE, KY 41042-1201
(859) 371-4020
(859) 746-7464
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
80903644
KY
05
90040080
KY
01
C11409
RR MEDICARE
KY
Enumeration date
10/20/2006
Last updated
02/12/2010
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