Individual
GARY NATHANAEL WORTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2353 ALEXANDRIA DR STE 260, LEXINGTON, KY 40504-3208
(859) 224-2655
(859) 223-7147
Mailing address
2353 ALEXANDRIA DR STE 260, LEXINGTON, KY 40504-3208
(859) 224-2655
(859) 223-7147
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
40650
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000571982
ANTHEM
KY
01
—
0744160
CIGNA
KY
01
—
40650
KY MEDICAL LICENSE
KY
05
—
7100063600
—
KY
01
—
9293157
AETNA
KY
01
—
ME104362
MEDICAL LICENSE
FL
Enumeration date
12/04/2006
Last updated
03/07/2023
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