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Individual

DR. BRADFORD MARTIN FINE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DPM

Contact information

Practice address
1401 HARRODSBURG RD, C115, LEXINGTON, KY 40504-3751
(859) 278-8855
(859) 278-8856
Mailing address
1401 HARRODSBURG RD, C115, LEXINGTON, KY 40504-3751
(859) 278-8855
(859) 278-8856

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
00313
KY
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
00313
KY
213ES0103X
Foot & Ankle Surgery Podiatrist
PO3163
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
6569
MEDICARE GROUP
KY
05
7100003410
KY
01
80900061
MEDICAID GROUP
KY
Enumeration date
06/02/2006
Last updated
10/30/2007
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