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Organization

BLUEGRASS FOOT AND ANKLE CARE

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. RANDALL W HALL DPM (OWNER/DPM)
(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

Taxonomy

Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
00274
KY
332BC3200X
Customized Equipment (DME)
Primary
00274
KY

Other

Enumeration date
11/06/2007
Last updated
09/19/2019
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