Kornely Podiatry, Llc

LBN: Kornely Podiatry, Llc
Kornely Podiatry, Llc is an health care organization with primary practice located at 2358 W Washington St , West Bend WI 53095-2118. The organization recently has 2 registered licenses in different health care specialties including Podiatric Medicine & Surgery Service Providers / Podiatrist, Suppliers / Durable Medical Equipment & Medical Supplies. Podiatric Medicine & Surgery Service Providers / Podiatrist is the primary health care specialty. Kornely Podiatry, Llc can be contacted via phone (262) 335-2930, or through Kornely, Lisa G. via phone (262) 335-2930.

Contact Information

Primary practice address
2358 W Washington St West Bend WI 53095-2118
Phone: (262) 335-2930
Fax: (262) 335-2931
Website:
Map and Directions
Authorized official contact:
Name: Kornely, Lisa G. Doctor of Podiatric Medicine (DPM)
Phone: (262) 335-2930

Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Podiatrist 213E00000X 774-025 Wisconsin
Suppliers / Durable Medical Equipment & Medical Supplies 332B00000X

Profile Details

NPI number 1861449720
LBN Legal business name Kornely Podiatry, Llc
DBA Doing business as
Authorized official Kornely, Lisa G. Doctor of Podiatric Medicine (DPM)
Entity Organization
Organization subpart 1 No
Enumeration date May 27th, 2006
Last updated Feb 1st, 2022 - about 3 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1861449720 NPPES
Wisconsin MEDICAID 43225400

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