Individual
JOHN WESLEY PRINCE JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
55 FOUNDATION DR, FLEMINGSBURG, KY 41041-9815
(859) 335-9041
(859) 335-9072
Mailing address
PO BOX 1650, AKRON, OH 44309-1650
(330) 864-8900
(330) 869-8924
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
36068
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000259709
ANTHEM
KY
01
—
50005474
PASSPORT
KY
05
—
64046618
—
KY
01
—
P00015881
RR-MEDICARE
KY
Enumeration date
07/24/2006
Last updated
12/14/2016
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