Most Relevant Information
Provider Data
| NPI Number: | 1003432923 |
| Provider Name: | ALEX WIEGEL DO |
| Entity Type: | Individual |
| Taxonomy Code: | 390200000X |
| Specialty: | Student in an Organized Health Care Education/Training Program |
| License Number: |
Most Important Dates
| Enumeration Date: | 06/17/2020 |
| Last Updated: | 08/22/2023 |
Provider Practice Location
100 MALLARD CREEK RD
LOUISVILLE
KY
402074194
Practice Location Phone/Fax
| Phone: | 5028556130 |
| Fax: |
Provider Mailing Location
PO BOX 776351
CHICAGO
IL
606776351
Provider Mailing Phone/Fax
| Phone: | 5025599425 |
| Fax: |