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Individual

DR. MARK ALLEN CARTER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
3907 JENICA WAY, LOUISVILLE, KY 40241-1530
(502) 412-2200
(502) 429-3657
Mailing address
3907 JENICA WAY, LOUISVILLE, KY 40241-1530
(502) 412-2200
(502) 429-3657

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
26799
KY
208D00000X
General Practice Physician
26799
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000844478
ANTHEM
KY
01
000001099444
ANTHEM
KY
01
152001
SIHO
KY
05
7100054880
KY
01
K087021
MEDICARE
KY
01
P01349710
RAILROAD MEDICARE
KY
Enumeration date
08/14/2006
Last updated
11/21/2017
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