Individual
ERIN WADDELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
716 W MAIN ST, MOREHEAD, KY 40351-1444
(606) 780-5364
Mailing address
716 W MAIN ST, MOREHEAD, KY 40351-1444
(606) 780-5364
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
55298
KY
390200000X
Student in an Organized Health Care Education/Training Program
—
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
55298
KY MEDICAL LICENSE
KY
Enumeration date
05/11/2018
Last updated
08/12/2021
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