Individual
BRENDEN M WETHERTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
727 HOSPITAL DR, SHELBYVILLE, KY 40065-1660
(502) 647-4347
Mailing address
PO BOX 8, LOUISVILLE, KY 40201-0008
(800) 476-8646
(919) 382-3210
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
35884
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000060164
BCBS GROUP #
KY
01
—
000000275811
BCBS GROUP # SAME
KY
05
—
64035520
—
KY
Enumeration date
06/10/2005
Last updated
07/09/2007
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