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Individual

NATHAN WIEBRACHT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
40 N GRAND AVE STE 101, FORT THOMAS, KY 41075-1765
(859) 781-4900
Mailing address
368 BIELBY RD, STE 140, LAWRENCEBURG, IN 47025-1067
(859) 781-4900

Taxonomy

Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
52371
KY
207Y00000X
Otolaryngology Physician
57-024381
OH
207YX0602X
Otolaryngic Allergy Physician
52371
KY

Other

Enumeration date
04/05/2014
Last updated
01/19/2021
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