Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Theodore M Wandzilak, MD

Individual provider Ophthalmology Physician · NPI 1013909753

Theodore M Wandzilak, MD is an Ophthalmology Physician in Louisville, Kentucky. Practices as a sole proprietor. Licensed in Kentucky.

Licensed in
KY
In the registry since
2005
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

1348 Poplar Level Rd
Louisville, KY 40217-1307
Phone: (502) 634-8100
Fax: (502) 637-6396
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Ophthalmology Physician (primary) Taxonomy 207W00000X · Licence 22152 (KY)

Record details

NPI number1013909753
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorYes
NPI enumeratedAugust 18, 2005
Last updated in NPPESJanuary 9, 2008

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