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Individual

JOHN L. WILHELMUS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1221 S BROADWAY, LEXINGTON, KY 40504-2701
(859) 258-4000
(859) 258-4796
Mailing address
1221 S BROADWAY, LEXINGTON, KY 40504-2701
(859) 258-4000
(859) 258-4796

Taxonomy

Speciality
Code
Description
License number
State
207ZC0500X
Cytopathology Physician
Primary
19828
KY
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
19828
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
37903705
MEDICAID LAB GRP
KY
01
4000501
MEDICARE LAB GRP
KY
05
64198286
KY
01
CB5773
RR MEDICARE GRP
GA
Enumeration date
07/26/2006
Last updated
11/02/2007
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