Organization
MARK R KUTYLA DPM PA
Active
Parent organization
MARK R KUTYLA DPM PA
Other names
MIDLANDS FOOT CLINIC
Organization subpart
Yes
Provider details
NPI number
Legal business name
MARK R KUTYLA DPM PA
Authorized official
DR. MARK R KUTYLA D.P.M. (PRESIDENT)
(803) 356-4712
Entity
Organization
Contact information
Practice address
121 PARK PLACE CT, LEXINGTON, SC 29072-6690
(803) 356-4712
(803) 356-0832
Mailing address
121 PARK PLACE CT, LEXINGTON, SC 29072-6690
(803) 356-4712
(803) 356-0832
Taxonomy
Speciality
Code
Description
License number
State
213EP1101X
Primary Podiatric Medicine Podiatrist
Primary
516
SC
213ER0200X
Radiology Podiatrist
516
SC
213ES0000X
Sports Medicine Podiatrist
516
SC
213ES0131X
Foot Surgery Podiatrist
516
SC
2471M1202X
Magnetic Resonance Imaging Radiologic Technologist
516
SC
332B00000X
Durable Medical Equipment & Medical Supplies
516
SC
332BC3200X
Customized Equipment (DME)
516
SC
335E00000X
Prosthetic/Orthotic Supplier
516
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1020003
ACM # MIDLANDS FOOT CL.
SC
01
—
42D2021725
CLIA CERTIFICATE OF WAIVER
SC
01
—
7238051
AETNA PROVIDER NO.
SC
Enumeration date
05/22/2006
Last updated
11/06/2011
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us