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Organization

DR. MARK J. EDMUNDS, DPM, P.L.L.C.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MARK J. EDMUNDS DPM (DIRECTOR OWNER)
(270) 885-1203
Entity
Organization

Contact information

Practice address
1610 S MAIN ST, SUITE 9, HOPKINSVILLE, KY 42240-1974
(270) 885-1203
(270) 885-1561
Mailing address
1610 S MAIN ST, SUITE 9, HOPKINSVILLE, KY 42240-1974
(270) 885-1203
(270) 885-1561

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
00294
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
8000049000
KY
01
DD3588
RAILROAD MEDICARE
Enumeration date
01/27/2006
Last updated
08/20/2008
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