Individual ProviderIsabelita P WijangcoInternal MedicineAllopathic & Osteopathic PhysiciansPractice Address250 E Liberty St, Suite 410, Louisville, KY 40202-1530(502) 587-0521PECOS EnrollmentBased on the most recent information from CMS, provider Isabelita P Wijangco does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 11 days ago.Profile DetailsProvider ID1659392991Provider TypeIndividualFull NameWijangco, Isabelita PTitleDr.CredentialM.D.GenderFemaleSole ProprietorNoEnumeration Date7/22/2006Last Updated8/7/2012Contact InformationPractice LocationPractice Address250 E Liberty St, Suite 410, Louisville, KY 40202-1530Phone(502) 587-0521Fax(502) 587-3885Mailing LocationMailing Address250 E Liberty St, Suite 410, Louisville, KY 40202-1530Phone(502) 587-0521Fax(502) 587-3885Provider TaxonomiesCodeDescriptionLicenseCode207R00000XPrimaryDescriptionInternal MedicineAllopathic & Osteopathic PhysiciansLicense17252KentuckyProvider IdentifiersIDDescriptionIssuerID64172521DescriptionMedicaidIssuerUnlistedKentuckyID1659392991DescriptionOtherIssuerNPIKentucky