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General NPI Number Information
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NPI Number | 1912939331
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Entity Type | Individual
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Provider Name | RONALD JOSEPH WURTH M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/07/2006
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Last Update Date | 02/14/2008
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Provider Practice Location Address
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Address Line | 913 N DIXIE AVE
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City | ELIZABETHTOWN
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State | KY
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Zip | 42701-2503
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Country | US
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Telephone | 270-706-1110
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Fax | 270-706-1058
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Provider Business Mailing Address
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Address Line | PO BOX 2119
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City | ELIZABETHTOWN
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State | KY
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Zip | 42702-2119
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Country | US
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Telephone | 270-737-1212
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 37993
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License Number State | KY
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