Provider Demographics
NPI:1831311547
Name:WOHLGEMUTH, TROY CHRISTOPHER (DC)
Entity Type:Individual
Prefix:DR
First Name:TROY
Middle Name:CHRISTOPHER
Last Name:WOHLGEMUTH
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3225 BRECKENRIDGE LN
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40220-2011
Mailing Address - Country:US
Mailing Address - Phone:502-491-0345
Mailing Address - Fax:502-491-0347
Practice Address - Street 1:3225 BRECKENRIDGE LN
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40220-2011
Practice Address - Country:US
Practice Address - Phone:502-491-0345
Practice Address - Fax:502-491-0347
Is Sole Proprietor?:No
Enumeration Date:2007-05-03
Last Update Date:2010-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY4527111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY85000966Medicaid
KY2437736000OtherPASSPORT ADVANTAGE
KY7725133OtherAETNA INSURANCE
KY1132137OtherPASSPORT HEALTH PLAN
KY1817604OtherFIRST HEALTH
KY7212253001OtherCIGNA INSURANCE
KY000000562903OtherANTHEM
KY4400449OtherUNITED HEALTHCARE
KY7212253001OtherCIGNA INSURANCE