Individual
JIANXIA WANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6411 VETERANS MEMORIAL PKWY, CRESTWOOD, KY 40014-8698
(502) 241-8611
(502) 241-4175
Mailing address
PO BOX 776351, CHICAGO, IL 60677-6351
(502) 272-5063
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
103281
GA
207Q00000X
Family Medicine Physician
Primary
48857
KY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/22/2013
Last updated
03/07/2025
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