MEDICARE: DR. JAMES E. WHEELER M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	34850	KY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	50032126	OTHER	KY	PASSPORT
2	000000708712	OTHER	KY	ANTHEM
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1275537094
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAMES E. WHEELER M.D.

Provider Business Mailing Address
First Line	:	PO BOX 950248
Second Line	:
City	:	LOUISVILLE
State	:	KY
Zip	:	40295-0248
Country	:	US
Telephone Number	:	502-489-5730
Fax Number	:	502-489-5753

Provider Business Practice Location Address
First Line	:	10216 TAYLORSVILLE RD
Second Line	:	STE 400
City	:	LOUISVILLE
State	:	KY
Zip	:	40299-3616
Country	:	US
Telephone Number	:	502-267-5456
Fax Number	:	502-267-5488

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/09/2005
Last Update Date	:	12/10/2020

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