Wallace Lyle Past Sr, MD in Crestwood, KY - General Practice

Wallace Lyle Past Sr, MD is a General Practice physician based in Crestwood, Kentucky. Wallace Lyle Past Sr is licensed to practice in Indiana (license number 01018231A) and his current practice location is 4608 Heritage Manor, Crestwood, Kentucky. He can be reached at his office (for appointments etc.) via phone at (502) 614-6688.

NPI number for Wallace Lyle Past Sr is 1871868802 and his current mailing address is 4608 Heritage Manor, Crestwood, Kentucky. He does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1871868802.

Contact Information

	Wallace Lyle Past Sr, MD
	4608 Heritage Manor, Crestwood, KY 40014
	(502) 614-6688
	(502) 614-6688

Physician's Profile

Full Name	Wallace Lyle Past Sr
Gender	Male
Speciality	General Practice
Location	4608 Heritage Manor, Crestwood, Kentucky
Accepts Medicare Assignments	Does not participate in Medicare Program. He may not accept medicare assignment.

NPI Data:

NPI Number: 1871868802
Provider Enumeration Date: 03/08/2012
Last Update Date: 03/08/2012

Medical Identifiers

Medical identifiers for Wallace Lyle Past Sr such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1871868802	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
208D00000X	General Practice	01018231A (Indiana)	Primary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Wallace Lyle Past Sr is NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Wallace Lyle Past Sr, MD 4608 Heritage Manor, Crestwood, KY 40014 Ph: (502) 614-6688	Wallace Lyle Past Sr, MD 4608 Heritage Manor, Crestwood, KY 40014 Ph: (502) 614-6688

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General Practice Doctors in Crestwood, KY

Dr. Ashok Alur, MD
General Practice
Medicare: Medicare Enrolled
Practice Location: 6520 W Hwy 22, Crestwood, KY 40014
Phone: 502-241-8488 Fax: 502-241-7424

Wallace Lyle Past Sr, MD - General Practice in Crestwood, KY