Individual
DR. PETER H WAYNE III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4003 KRESGE WAY STE 300, LOUISVILLE, KY 40207-4652
(502) 897-5139
(502) 638-4794
Mailing address
4003 KRESGE WAY STE 300, SUITE 100, LOUISVILLE, KY 40207-4652
(502) 897-5139
(502) 638-4794
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
18914
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
64189145
—
KY
Enumeration date
07/25/2006
Last updated
03/17/2015
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