Provider Demographics
NPI:1538515127
Name:WOLFE, WHITNEY (DO)
Entity Type:Individual
Prefix:
First Name:WHITNEY
Middle Name:
Last Name:WOLFE
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 S 8TH ST STE 480W
Mailing Address - Street 2:
Mailing Address - City:MURRAY
Mailing Address - State:KY
Mailing Address - Zip Code:42071-2403
Mailing Address - Country:US
Mailing Address - Phone:270-762-1321
Mailing Address - Fax:270-762-1783
Practice Address - Street 1:803 POPLAR ST
Practice Address - Street 2:
Practice Address - City:MURRAY
Practice Address - State:KY
Practice Address - Zip Code:42071-2432
Practice Address - Country:US
Practice Address - Phone:270-762-1515
Practice Address - Fax:270-752-2852
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-12
Last Update Date:2023-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYC0604208M00000X
390200000X
MELT21012208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program