Organization
CARL H. ROSEN, M.D.
Active
Other names
Brandenburg Urology
Organization subpart
No
Provider details
NPI number
Authorized official
CARL H ROSEN MD (OWNER)
(270) 287-0450
Entity
Organization
Contact information
Practice address
6373 BRANDENBURG RD, LEITCHFIELD, KY 42754-7534
(270) 215-1036
Mailing address
6373 BRANDENBURG RD, LEITCHFIELD, KY 42754-7534
(270) 215-1036
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000612641
ANTHEM BCBS
—
01
—
50023039
PASSPORT HEALTH
KY
05
—
64300205
—
KY
Enumeration date
04/16/2009
Last updated
09/21/2009
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