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Organization

MCE EMERGENCY PHYSICIANS, PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. BRENDEN M WETHERTON MD (MEDICAL DIRECTOR)
(502) 454-4274
Entity
Organization

Contact information

Practice address
3920 DUTCHMANS LN, LOUISVILLE, KY 40207-4702
(502) 259-6005
Mailing address
PO BOX 3571, LOUISVILLE, KY 40201-3571
(800) 476-8646
(919) 382-3210

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000275811
BCBS OF KY 12 DIGIT GROUP
KY
01
50000548
PASSPORT HEALTH GROUP #
KY
05
65939480
KY
Enumeration date
06/17/2005
Last updated
07/21/2022
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