person
Dr. Mark Raymond Kutyla, DPM
Foot Surgery Podiatrist in Lexington, South Carolina
NPI 1326007022

Mark Raymond Kutyla is a Foot Surgery Podiatrist based in West Columbia, SC and is specialized in Foot Surgery. Mark Raymond Kutyla practices in Lexington, SC and has the professional credentials of DPM. The NPI Number for Mark Raymond Kutyla is 1326007022 and holds a License No. 516 (South Carolina).

The current practice location address for Mark Raymond Kutyla is 121 Park Place Ct, Lexington, SC and can be reached out via phone at 803-356-4712 and via fax at 803-356-0832. You can also correspond with Mark Raymond Kutyla through the mailing address at PO BOX 6069, WEST COLUMBIA, SC - 29171-6069 (mailing address contact number: ).

Location: 121 Park Place Ct, Lexington, SC, 29171-6069
person
Provider Profile Details
NPI Number
1326007022
Provider Name
Mark Raymond Kutyla
Credential
DPM
Provider Entity Type
Individual
Gender
Male
Address
121 Park Place Ct, Lexington, SC, 29171-6069
Phone Number
803-356-4712
Fax Number
803-356-0832
Provider Enumeration Date
03/21/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
1020003 01 SC ACM - MIDLANDS FOOT CLINIC
1326007022 01 SC NPI # MARK R KUTYLA DPM
7238051 01 SC AETNA PROVIDER
1720032816 01 SC NPI # FOR MIDLANDS FOOT CLINIC - PRIMARY PRACTICE LOCATION
42D2921723 01 SC CLIA CERTIFICATE OF WAIVER FOR NEWBERRY FOOT CLINIC LOCATION
1851338461 01 SC NPI # FOR NEWBERRY FOOT CLINIC - ADDITIONAL PRACTICE LOCATION
K066682 01 SC INTEGRATED HEALTH PLAN PROVIDER
0433675 01 SC CIGNA PROVIDER
480032059 01 SC MEDICARE RAILROAD PROVIDER
1015587 01 SC ACM - NEWBERRY FOOT CLINIC
42D2021725 01 SC CLIA CERTIFICATE OF WAIVER FOR MIDLANDS FOOT CLINIC LOCATION
institution
Provider Business Practice Location Address Details
Address
121 Park Place Ct
City
State
Zip
29072-6690
Phone Number
803-356-4712
Fax Number
803-356-0832
person
Provider Business Mailing Address Details
Address
Po Box 6069
City
State
Zip
29171-6069
Phone Number
Fax Number
person
Provider's Taxonomy Details 1
Type
Podiatric Medicine & Surgery Service Providers
Classification
Podiatrist
Speciality
Primary Podiatric Medicine
Taxonomy
License No.
516 (South Carolina)
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Podiatric Medicine & Surgery Service Providers
Classification
Podiatrist
Speciality
Radiology
Taxonomy
License No.
516 (South Carolina)
Definition
Definition to come...
person
Provider's Taxonomy Details 3
Type
Podiatric Medicine & Surgery Service Providers
Classification
Podiatrist
Speciality
Sports Medicine
Taxonomy
License No.
516 (South Carolina)
Definition
Definition to come...
person
Provider's Taxonomy Details 4
Type
Podiatric Medicine & Surgery Service Providers
Classification
Podiatrist
Speciality
Foot Surgery
Taxonomy
License No.
516 (South Carolina)
Definition
Definition to come...
person
Provider's Taxonomy Details 5
Type
Technologists, Technicians & Other Technical Service Providers
Classification
Radiologic Technologist
Speciality
Magnetic Resonance Imaging
Taxonomy
License No.
516 (South Carolina)
Definition
Definition to come...
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