Individual
DR. MICHAEL JASON WALLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2845 CHANCELLOR DR, CRESTVIEW HILLS, KY 41017-3418
(859) 301-2663
(859) 817-7848
Mailing address
560 S LOOP RD, EDGEWOOD, KY 41017-3405
(859) 301-2663
(859) 817-7848
Taxonomy
Speciality
Code
Description
License number
State
208VP0014X
Interventional Pain Medicine Physician
Primary
42678
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000001148521
ANTHEM ID
—
01
—
003031812
UNITED HEALTHCARE PROVIDER ID NUMBER
—
05
—
0295938
—
OH
01
—
15725575
WELLCARE OF KENTUCKY PROVIDER ID NUMBER
KY
01
—
298418KYIP
AETNA BETTER HEALTH OF KENTUCKY PROVIDER ID NUMBER
KY
05
—
300012365
—
IN
05
—
7100086870
—
KY
01
—
9318357
AETNA PIN
—
01
—
CS1811400200
CARESOURCE ID
—
01
—
P02011197
RAILROAD MEDICARE
KY
Enumeration date
04/17/2008
Last updated
12/20/2024
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us