Individual
DR. MARK PAUL CARUSO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
713 BROADWAY ST STE 203, PAINTSVILLE, KY 41240-1612
(606) 789-4949
(606) 789-7690
Mailing address
713 BROADWAY ST, STE 203, PAINTSVILLE, KY 41240-1612
(606) 789-4949
(606) 789-7690
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
26513
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000049250
ANTHEM BC BS
KY
01
—
018956500
US DEPT. OF LABOR
KY
01
—
11026000
RR MEDICARE UHC
KY
05
—
64265135
—
KY
Enumeration date
11/07/2006
Last updated
06/20/2013
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