Myrick, Keith Wellington

Myrick, Keith Wellington is an individual health care provider with primary practice located at 6400 Dutchmans Pkwy Suite 215, Louisville KY 40205-3340. He recently has only one registered license in Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery, which is considered as his primary health care specialty. Myrick, Keith Wellington can be contacted via phone (502) 721-8288.

Contact Information

Primary practice address
6400 Dutchmans Pkwy Suite 215 Louisville KY 40205-3340
Phone: (502) 721-8288
Fax: (502) 721-8792
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery 213ES0103X 251 Kentucky

Profile Details

NPI number 1063402972
LBN Legal business name Myrick, Keith Wellington
Credentials Doctor of Podiatric Medicine (DPM)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 24th, 2005
Last updated Aug 30th, 2016 - about 10 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 1063402972 NPPES
Kentucky Other 0000000382017 BLUE PREFERRED (ANTHEM)
Kentucky MEDICAID 201363620 BLUE PREFERRED (ANTHEM)
Kentucky MEDICAID 80000318 BLUE PREFERRED (ANTHEM)
Kentucky Other 50007597 BLUE PREFERRED (ANTHEM)

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