1700816493 NPI number — DR. WESLEY MOREFIELD D.C.

Table of content: DR. WESLEY MOREFIELD D.C. (NPI 1700816493)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1700816493 NPI number — DR. WESLEY MOREFIELD D.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MOREFIELD
Provider First Name:
WESLEY
Provider Middle Name:
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
D.C.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1700816493
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/07/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7030 US HIGHWAY 68
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PADUCAH
Provider Business Mailing Address State Name:
KY
Provider Business Mailing Address Postal Code:
42003-9108
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
270-898-2111
Provider Business Mailing Address Fax Number:
270-898-2112

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7030 US HIGHWAY 68
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PADUCAH
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
42003-9108
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
270-898-2111
Provider Business Practice Location Address Fax Number:
270-898-2112
Provider Enumeration Date:
07/05/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X , with the licence number:  4933 , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 670409 . This is a "ACN" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 708614 . This is a "HEALTHLINK" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 1223580 . This is a "CHA" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 7036717 . This is a "AETNA" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: P00406875 . This is a "RRMEDICARE" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 00000364523 . This is a "BC/BS" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 670409117532 . This is a "UHC" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".




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