Individual
RONALD D WEDDLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
7926 PRESTON HWY, STE. 106, LOUISVILLE, KY 40219-3848
(502) 964-4357
(502) 966-5948
Mailing address
PO BOX 776351, CHICAGO, IL 60677-6351
(502) 588-9490
(502) 272-5116
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
17429
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
133731
SIHO- NCMA
KY
05
—
64174295
—
KY
01
—
K037340
MEDICARE- NORTON MEDICAL ASSOCIATES
KY
Enumeration date
08/10/2005
Last updated
03/27/2017
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