Organization
CHRISTIAN COUNTY FOOT AND ANKLE CENTER, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK J EDMUNDS DPM (PRESIDENT)
(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
—
KY
332B00000X
Durable Medical Equipment & Medical Supplies
00294
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100074830
—
KY
05
—
7100095890
—
KY
01
—
DO8812
RR MCAR #
KY
Enumeration date
05/21/2008
Last updated
03/22/2016
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