Individual
RODNEY QUINN WISDOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
5306 BARDSTOWN RD, LOUISVILLE, KY 40291-1931
(502) 499-7744
(502) 499-4928
Mailing address
4214 BERKSHIRE AVE, LOUISVILLE, KY 40220-1155
(502) 499-7744
(502) 499-4928
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
4078
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000375026
BLUE CROSS BLUE SHIELD
KY
01
—
270696
PHCS
KY
01
—
7993
MEDICARE GROUP NUMBER
KY
01
—
8735432
CIGNA
KY
01
—
DD7594
RAILROAD MEDICARE GROUP #
KY
Enumeration date
02/15/2006
Last updated
11/30/2007
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