Healthcare Provider Details

I. General information

NPI: 1669439071
Provider Name (Legal Business Name): THOMAS L WOLFORD MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/28/2006
Last Update Date: 08/07/2026
Certification Date: 08/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1301 PLEASANT VALLEY RD STE 202
OWENSBORO KY
42303-9774
US

IV. Provider business mailing address

707 SHERIDAN AVE
CODY WY
82414-3409
US

V. Phone/Fax

Practice location:
  • Phone: 270-417-7500
  • Fax: 270-417-7509
Mailing address:
  • Phone: 307-527-7501
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License NumberME83191
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number166435
License Number StateKY
# 3
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberMED-PHYS-LIC-77127
License Number StateMT
# 4
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number12316A
License Number StateWY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: