# ROBERT L WYENANDT JR,MD PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1538159751
- **Authorized official:** ROBERT L WYENANDT JR. MD (OWNER)
- **Authorized official phone:** (859) 341-6255

## Contact information

- **Practice address:** 2156 CHAMBER CENTER DR, LAKESIDE PARK, KY 41017-1669
- **Practice address phone:** (859) 341-6255
- **Practice address fax:** (859) 547-1197
- **Mailing address:** 2156 CHAMBER CENTER DR, LAKESIDE PARK, KY 41017-1669
- **Mailing address phone:** (859) 341-6255
- **Mailing address fax:** (859) 547-1197

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 10/27/2005
- **Last updated:** 02/19/2008