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Individual

DR. BRIAN PRZYSTAWSKI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DPM, PSC

Contact information

Practice address
4119 BROWNS LN, BLDG 2, LOUISVILLE, KY 40220-1500
(502) 454-4187
(502) 454-4235
Mailing address
PO BOX 909, LOUISVILLE, KY 40201-0909
(502) 588-0328
(502) 454-4235

Taxonomy

Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
07000635
IN
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
195
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000051908
ANTHEM
IN
01
000000051908
ANTHEM
KY
01
000000051908
IN COMPREHENSIVE
05
1054641
KY
01
215680
MEDICARE GROUP
IN
01
2433700000
PASSPORT ADVANTAGE
01
480027403
RAILROAD MEDICARE
01
611327502
HUMANA
05
80001951
KY
01
9209
MEDICARE GROUP
KY
Enumeration date
12/13/2005
Last updated
10/15/2024
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