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General NPI Number Information
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NPI Number | 1629073325
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Entity Type | Organization
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Legal Business Name | MCE EMERGENCY PHYSICIANS, PLLC
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Dates
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Enumeration Date | 06/17/2005
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 3920 DUTCHMANS LN
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City | LOUISVILLE
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State | KY
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Zip | 40207-4702
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Country | US
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Telephone | 502-259-6005
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 3571
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City | LOUISVILLE
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State | KY
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Zip | 40201-3571
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Country | US
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Telephone | 800-476-8646
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Fax | 919-382-3210
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. BRENDEN M WETHERTON
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Credential | MD
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Telephone | 502-454-4274
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number |
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License Number State | KY
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