Individual
DR. GREGORY P WECKENBROCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
830 THOMAS MORE PKWY, STE 203, EDGEWOOD, KY 41017-5102
(859) 341-5757
(859) 331-4757
Mailing address
830 THOMAS MORE PKWY, STE 203, EDGEWOOD, KY 41017-5102
(859) 341-5757
(859) 331-4757
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
23567
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0638582
—
OH
05
—
64235674
—
KY
Enumeration date
07/17/2006
Last updated
09/21/2007
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