Individual
LARRY WHEELER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
C.PED
Contact information
Practice address
371 SOUTHLAND DR, LEXINGTON, KY 40503-1824
(859) 266-0420
(859) 266-0667
Mailing address
371 SOUTHLAND DR, LEXINGTON, KY 40503-1824
(859) 266-0420
(859) 266-0667
Taxonomy
Speciality
Code
Description
License number
State
224L00000X
Pedorthist
Primary
111233
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000519294
ANTHEM BC/BS
KY
01
—
208278527
HUMANA
KY
01
—
5574649
AETNA
KY
01
—
5939230001
MEDICARE DME
KY
05
—
7100026770
—
KY
Enumeration date
08/16/2006
Last updated
11/21/2016
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