Individual
KEITH S WEXLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2008 W BOULEVARD, KOKOMO, IN 46902-6079
(765) 454-9729
Mailing address
PO BOX 1644, INDIANAPOLIS, IN 46206-1644
(866) 494-8258
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
01049185A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000363371
BC/BS INDIVIDUAL PIN NO
IN
01
—
P00256278
RAILROAD MEDICARE
IN
Enumeration date
07/08/2005
Last updated
07/18/2007
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