Provider Demographics
NPI:1356403489
Name:MIERS, WENDELL RANCE (MD)
Entity type:Individual
Prefix:DR
First Name:WENDELL
Middle Name:RANCE
Last Name:MIERS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:3084 LAKECREST CIRCLE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40513
Mailing Address - Country:US
Mailing Address - Phone:859-639-1210
Mailing Address - Fax:859-639-1211
Practice Address - Street 1:3084 LAKECREST CIRCLE
Practice Address - Street 2:SUITE 100
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40513
Practice Address - Country:US
Practice Address - Phone:859-639-1210
Practice Address - Fax:859-639-1211
Is Sole Proprietor?:No
Enumeration Date:2006-12-14
Last Update Date:2024-08-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KY35330207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY000000067559OtherANTHEM BCBS
460002371OtherRAILROAD MEDICARE
KYG06037OtherBLUEGRASS FAMILY HEALTH
KY1177383OtherCHA
KY64993579Medicaid
KY64993579Medicaid
KY1177383OtherCHA