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Individual

DR. WAYNE HENDRIX

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1225 FAIRWAY ST, BOWLING GREEN, KY 42103-2477
(270) 796-3910
(270) 842-7177
Mailing address
PO BOX 3240, BOWLING GREEN, KY 42102-3240
(270) 796-3910
(270) 842-7177

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
21076
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000044746
ANTHEM
KY
01
260003553
RAILROAD MEDICARE
KY
01
50006916
PASSPORT
KY
05
64210768
KY
Enumeration date
06/09/2005
Last updated
11/26/2012
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