Individual
AMANDA L DENZIK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPM
Contact information
Practice address
4612 OUTER LOOP, LOUISVILLE, KY 40219-3971
(502) 968-2233
(502) 968-2283
Mailing address
4612 OUTER LOOP, LOUISVILLE, KY 40219-3971
(502) 804-4811
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
07001180A
IN
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
243983
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000880754
ANTHEM
KY
05
—
201243030
—
IN
01
—
50071771
PASSPORT HEALTH PLAN
KY
05
—
7100307170
—
KY
01
—
P01370863
RAILROAD MEDICARE
IN
Enumeration date
07/12/2011
Last updated
07/15/2021
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