Bluegrass Podiatric Management LLC
NPI #1720477672 in Louisville, Kentucky
Provider Information
- NPI Number
- 1720477672
- Entity Type
- Organization
- Organization Name
- Bluegrass Podiatric Management LLC
- Primary Specialty
- Podiatrist
- Enumeration Date
- Jan 15, 2015
- Last Updated
- Oct 29, 2024
Practice Location
- Address
- 9800 SHELBYVILLE RD STE 202
- City
- Louisville
- State
- Kentucky
- ZIP Code
- 40223-5440
- Phone
- (502) 536-7224
Authorized Official
- Name
- ANGIE LASORELLA
- Title
- CREDENTIALING SUPERVISOR
- Phone
- (513) 829-9333
Specialties & Taxonomy Codes
| Specialty |
|---|
| Nurse Practitioner |
| Podiatrist |
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| DR. Thomas Wayne Childress JR., D.P.M | |
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| DR. William Ottis Mcglone III, DPM | |
| DR. Larry K Ketcherside, DPM | |
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