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Individual

DR. RANDY L. WOLFE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1325 TRIPLETT ST, OWENSBORO, KY 42303-3163
(270) 688-4325
Mailing address
PO BOX 1395, OWENSBORO, KY 42302-1395
(270) 688-4325

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
18397
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000198726
ANTHEM BLUE CROSS/SHIELD
KY
01
50002978
PASSPORT
KY
05
64183973
KY
05
65934259
KY
01
7513462
CIGNA
KY
Enumeration date
06/02/2005
Last updated
07/09/2007
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