Individual
BRUCE ALEXANDER WOLF
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
906 WOODLAND DR, SUITE 102, ELIZABETHTOWN, KY 42701-2752
(270) 765-5127
(270) 765-2653
Mailing address
906 WOODLAND DR, SUITE 102, ELIZABETHTOWN, KY 42701-2752
(270) 765-5127
(270) 765-2653
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
21707
KY
208200000X
Plastic Surgery Physician
21707
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
64217078
—
KY
Enumeration date
08/03/2005
Last updated
10/08/2010
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