Individual
RYAN D. WADDLES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1221 S BROADWAY, LEXINGTON, KY 40504-2701
(859) 258-4539
(859) 258-4870
Mailing address
1221 S BROADWAY, LEXINGTON, KY 40504-2701
(859) 258-4530
(859) 258-4870
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
35018
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
64350184
—
KY
Enumeration date
07/21/2006
Last updated
03/01/2021
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