Individual
A LYNN WOMACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1331 CASTLEWOOD AVE, LOUISVILLE, KY 40204-1502
(502) 767-7778
Mailing address
1331 CASTLEWOOD AVE, LOUISVILLE, KY 40204-1502
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
19673
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080025492
MEDICARE ID TYPE UNSPECIF
KY
Enumeration date
07/30/2006
Last updated
12/13/2022
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