Individual
WYCLIFFE OPII
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
900 S LIMESTONE, 304B CHARLES T. WETHINGTON BUILDING, LEXINGTON, KY 40536-0200
(859) 323-9918
(859) 323-1197
Mailing address
900 S LIMESTONE, 304B CHARLES T. WETHINGTON BUILDING, LEXINGTON, KY 40536-0200
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
R3292
KY
Other
Enumeration date
04/18/2013
Last updated
12/07/2020
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