Organization
BLUEGRASS FOOT AND ANKLE CARE, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RANDALL W. HALL D.P.M. (BUSINESS OWNER)
(859) 623-3550
Entity
Organization
Contact information
Practice address
326 HIGHLAND PARK DR, RICHMOND, KY 40475-3487
(859) 623-3550
Mailing address
326 HIGHLAND PARK DR, RICHMOND, KY 40475-3487
(859) 623-3550
(859) 623-3393
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
00274
KY
332B00000X
Durable Medical Equipment & Medical Supplies
00274
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000330835
ANTHEM
KY
05
—
7100051420
—
KY
05
—
90011214
—
KY
Enumeration date
03/07/2007
Last updated
09/20/2019
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