institution
Mark R Kutyla Dpm Pa
Prosthetic/Orthotic Supplier in Lexington, South Carolina
NPI 1720032816

Mark R Kutyla Dpm Pa is a Prosthetic/Orthotic Supplier based in Lexington, SC. Mark R Kutyla Dpm Pa practices in Lexington, SC. The NPI Number for Mark R Kutyla Dpm Pa is 1720032816 and holds a License No. 516 (South Carolina).

The current practice location address for Mark R Kutyla Dpm Pa 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 R Kutyla Dpm Pa through the mailing address at 121 PARK PLACE CT, LEXINGTON, SC - 29072-6690 (mailing address contact number: 803-356-4712).

Location: 121 Park Place Ct, Lexington, SC, 29072-6690
institution
Provider Profile Details
NPI Number
1720032816
Provider Name
Mark R Kutyla Dpm Pa
Credential
Provider Entity Type
Organization
Address
121 Park Place Ct, Lexington, SC, 29072-6690
Phone Number
803-356-4712
Fax Number
803-356-0832
Provider Enumeration Date
05/22/2006
Last Update Date
03/12/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
7238051 01 SC AETNA PROVIDER NO.
1020003 01 SC ACM # MIDLANDS FOOT CL.
42D2021725 01 SC CLIA CERTIFICATE OF WAIVER
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
121 Park Place Ct
City
State
Zip
29072-6690
Phone Number
803-356-4712
Fax Number
803-356-0832
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...
person
Provider's Taxonomy Details 6
Type
Suppliers
Classification
Durable Medical Equipment & Medical Supplies
Speciality
-
Taxonomy
License No.
516 (South Carolina)
Definition
A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient's use in the home and that are usable for an extended period of time.
person
Provider's Taxonomy Details 7
Type
Suppliers
Classification
Durable Medical Equipment & Medical Supplies
Speciality
Customized Equipment
Taxonomy
License No.
516 (South Carolina)
Definition
Definition to come...
person
Provider's Taxonomy Details 8
Type
Suppliers
Classification
Prosthetic/Orthotic Supplier
Speciality
-
Taxonomy
License No.
516 (South Carolina)
Definition
An organization that provides prosthetic and orthotic care which may include, but is not limited to, patient evaluation, prosthesis or orthosis design, fabrication, fitting and modification to treat limb loss for purposes of restoring physiological function and/or cosmesis or to treat a neuromusculoskeletal disorder or acquired condition.
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