Provider Demographics
NPI:1386619203
Name:WHARTON, JAMES ROBERT (MD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:ROBERT
Last Name:WHARTON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:13802 LAKE POINT CIR STE 102
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40223-4219
Mailing Address - Country:US
Mailing Address - Phone:502-245-4450
Mailing Address - Fax:502-245-4462
Practice Address - Street 1:2195 HARRODSBURG RD STE 2
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40504-3516
Practice Address - Country:US
Practice Address - Phone:859-323-3376
Practice Address - Fax:859-323-0350
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-22
Last Update Date:2025-10-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KY40543207ND0900X
ARE0888207ND0900X
KY50543207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No207ND0900XAllopathic & Osteopathic PhysiciansDermatologyDermatopathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL012446900Medicaid
FLHX090ZMedicare PIN