Ketcherside, Larry K

Ketcherside, Larry K is an individual health care provider with primary practice located at 9110 Leesgate Rd , Louisville KY 40222-5053. He recently has only one registered license in Podiatric Medicine & Surgery Service Providers / Podiatrist, which is considered as his primary health care specialty. Ketcherside, Larry K can be contacted via phone (502) 426-7222.

Contact Information

Primary practice address
9110 Leesgate Rd Louisville KY 40222-5053
Phone: (502) 426-7222
Fax: (502) 425-8226
Website:
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Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Podiatrist 213E00000X 00358 Kentucky

Profile Details

NPI number 1083907471
LBN Legal business name Ketcherside, Larry K
Credentials Doctor of Podiatric Medicine (DPM)
Entity Individual
Sole proprietor 1 No
Enumeration date May 18th, 2011
Last updated Jan 31st, 2014 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1083907471 NPPES
Kentucky MEDICAID 7100165100

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