Provider Demographics
NPI:1619161809
Name:LATUNIK, WENDY ANN (MD)
Entity Type:Individual
Prefix:DR
First Name:WENDY
Middle Name:ANN
Last Name:LATUNIK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1733 HARRODSBURG RD
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40504-3277
Mailing Address - Country:US
Mailing Address - Phone:859-278-4869
Mailing Address - Fax:859-278-7690
Practice Address - Street 1:1733 HARRODSBURG RD
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40504-3277
Practice Address - Country:US
Practice Address - Phone:859-278-4869
Practice Address - Fax:859-278-7690
Is Sole Proprietor?:No
Enumeration Date:2007-08-30
Last Update Date:2022-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY42970207Q00000X, 207QG0300X, 207QH0002X
PA432313207QG0300X, 207QH0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QH0002XAllopathic & Osteopathic PhysiciansFamily MedicineHospice and Palliative Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100137930Medicaid
KY7100137930Medicaid