Theodore M Wandzilak, MD

NPI #1013909753 in Louisville, Kentucky

Provider Information

NPI Number: 1013909753
Entity Type: Individual
Name: Theodore M Wandzilak, MD
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Ophthalmology
Credential: MD
Enumeration Date: Aug 18, 2005
Last Updated: Jan 9, 2008

Practice Location

Address: 1348 POPLAR LEVEL RD
City: Louisville
State: Kentucky
ZIP Code: 40217-1307
Phone: (502) 634-8100

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Ophthalmology	207W00000X	Primary

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