Provider Demographics
NPI:1396017968
Name:FAULKNER, WESLEY W (PA-C)
Entity Type:Individual
Prefix:
First Name:WESLEY
Middle Name:W
Last Name:FAULKNER
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Gender:M
Credentials:PA-C
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Mailing Address - Street 1:1218 S. BROADWAY
Mailing Address - Street 2:STE 310
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40504-2759
Mailing Address - Country:US
Mailing Address - Phone:859-219-0542
Mailing Address - Fax:859-219-9433
Practice Address - Street 1:1218 S. BROADWAY
Practice Address - Street 2:STE 310
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40504-2759
Practice Address - Country:US
Practice Address - Phone:859-219-0542
Practice Address - Fax:859-219-9433
Is Sole Proprietor?:No
Enumeration Date:2012-01-30
Last Update Date:2012-01-30
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant