Organization
PAIGE PRIMARY CARE CENTER
Active
Other names
Carl D. Paige, MD, PSC
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CARLTON DAMON PAIGE M.D. (PRESIDENT)
(502) 225-4480
Entity
Organization
Contact information
Practice address
1023 NEW MOODY LN, SUITE 201, LA GRANGE, KY 40031-9177
(502) 225-4480
(502) 225-9169
Mailing address
1023 NEW MOODY LN, SUITE 201, LA GRANGE, KY 40031-9177
(502) 225-4480
(502) 225-9169
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
41864
KY
207R00000X
Internal Medicine Physician
—
—
208000000X
Pediatrics Physician
Primary
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100169030
—
KY
01
—
D0433
MEDICARE RR
KY
Enumeration date
05/11/2006
Last updated
01/24/2014
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