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Individual

WAYNE C PRETILA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
425 LEWIS HARGETT CIR, LEXINGTON, KY 40503-3590
(859) 268-1030
(859) 269-4120
Mailing address
1451 N GARDNER ST, SCOTTSBURG, IN 47170-7751
(812) 752-3456
(812) 752-5884

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
01026839A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100221310
IN
01
940540UU
LEGACY MEDICARE
IN
Enumeration date
02/20/2006
Last updated
06/01/2016
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