Organization
BLUEGRASS REGIONAL FOOT AND ANKLE ASSOCIATES PSC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAUL KARL KRESTIK DPM (PHYSICIAN)
(606) 862-9900
Entity
Organization
Contact information
Practice address
1907 EAST PITTSBURGH CHURCH ROAD, LONDON, KY 40741
(606) 260-8590
(606) 260-8591
Mailing address
1105 W. 5TH STREET, #3, LONDON, KY 40741-1610
(606) 862-9900
(606) 862-8901
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
90005737
—
KY
Enumeration date
05/25/2022
Last updated
09/07/2022
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