Iverson, Wayne Lawrence
Iverson, Wayne Lawrence is an sole proprietor health care provider with primary practice located at 16 Winchester Plz , Winchester KY 40391-1143. He recently has only one registered license in Allopathic & Osteopathic Physicians / Cardiovascular Disease, which is considered as his primary health care specialty. Iverson, Wayne Lawrence can be contacted via phone (859) 513-0078.Contact Information
Primary practice address
16 Winchester Plz
Winchester KY 40391-1143
Phone: (859) 513-0078
Fax: (859) 737-5020
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Cardiovascular Disease | 207RC0000X | G30486 | California |
| Allopathic & Osteopathic Physicians / Cardiovascular Disease | 207RC0000X | 50617 | Kentucky |
Profile Details
| NPI number | 1447397906 |
|---|---|
| LBN Legal business name | Iverson, Wayne Lawrence |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jan 31st, 2007 |
| Last updated | Dec 30th, 2020 - about 4 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1447397906 | NPPES |
| California | Other | G30486 | MEDICAL LINCENSE |
| California | Other | 05D0569343 | MEDICAL LINCENSE |
| California | MEDICAID | 7100563520 | MEDICAL LINCENSE |
| California | Other | 50617 | MEDICAL LINCENSE |
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