Organization
MARK A RISEN, DPM,
Active
Other names
CENTRAL KY FOOT SPECIALISTS
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK A RISEN DPM. (OWNER)
(270) 789-4342
Entity
Organization
Contact information
Practice address
1003 OLD GREENSBURG RD, CAMPBELLSVILLE, KY 42718-2571
(270) 789-4342
(270) 465-3305
Mailing address
1003 OLD GREENSBURG RD, CAMPBELLSVILLE, KY 42718-2571
(270) 789-4342
(270) 465-3305
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
00216
KY
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
80002165
—
KY
Enumeration date
07/13/2006
Last updated
09/01/2017
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