Wyatt Allen Stahl, MD
Individual provider Active NPI Student in an Organized Health Care Education/Training Program · Edgewood, KY
NPI 1780436345 · NPPES record last updated Apr 4, 2024
Key facts
- NPI
- 1780436345
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Student in an Organized Health Care Education/Training Program 390200000X
- Practice address
- 413 S Loop Rd
Edgewood, KY 41017-5446 - Phone
- (859) 301-3800
- Fax
- (859) 301-3987
- NPI assigned
- Apr 4, 2024
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Medicine
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | Yes |
Addresses
Primary practice location
413 S Loop Rd
Edgewood, KY 41017-5446
Mailing address
413 S Loop Rd
Edgewood, KY 41017-5446
Phone (859) 301-3800
Other providers in Edgewood, KY
- St. Elizabeth Medical Center, Inc.
- St. Elizabeth Medical Center, Inc.
- St. Elizabeth Medical Center, Inc.
- Austin Stacy
- Christina Staggs
- David M Stanforth
- Chase R Stanley
- Griffin Neal Stanley
- Marlene Starns
- Jeanne F Steele
All providers in Edgewood, KY · Student in an Organized Health Care Education/Training Program in Kentucky
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 4, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.