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Organization

WILLIAMSON FOOT CLINIC, PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. KENNETH BURTON AVERY D.P.M. (PODIATRIST)
(606) 237-5000
Entity
Organization

Contact information

Practice address
28531 US HIGHWAY 119 STE 202, SOUTH WILLIAMSON, KY 41503-3928
(606) 237-5000
(606) 237-5001
Mailing address
28531 US HIGHWAY 119 STE 202, SOUTH WILLIAMSON, KY 41503-3928
(606) 237-5000
(606) 237-5001

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
00295
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3810004941
WV
05
80900301
KY
Enumeration date
09/21/2006
Last updated
06/17/2008
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