Individual
RICHARD J. WIESEMANN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4001 DUTCHMANS LN, RADIOLOGY, LOUISVILLE, KY 40207-4714
(502) 893-1183
Mailing address
450 EXECUTIVE PARK, LOUISVILLE, KY 40207-4204
(502) 897-3214
(502) 897-7685
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
17400
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
64174006
—
KY
Enumeration date
07/12/2006
Last updated
08/26/2009
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