Individual
DR. WAJDI S KFOURY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1 TRILLIUM WAY, CORBIN, KY 40701-8727
(606) 526-4449
(606) 523-8581
Mailing address
PO BOX 182, CORBIN, KY 40702-0182
(606) 767-1577
(606) 523-8581
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
38881
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000358174
BCBS- EBMC LOC.
KY
01
—
000000521524
BCBS-KFOURY MED SPEC. LOC
KY
05
—
64089154
—
KY
Enumeration date
08/18/2005
Last updated
11/12/2019
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