Individual
DR. NICHOLAS LEROY WOLF
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
10232 WESTPORT RD, LOUISVILLE, KY 40241-2148
(502) 339-2042
Mailing address
11559 CUMBERLAND RD, SUITE 300, FISHERS, IN 46037-9784
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
18003526
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
18003526A/B
INDIANA OPTOMETRY LICENSE
IN
01
—
1879DT
KENTUCKY OPTOMETRY LICENSE
KY
Enumeration date
07/21/2008
Last updated
02/29/2012
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