Individual
LUIS M CARRASCO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
33347
KY
208000000X
Pediatrics Physician
Primary
E-9613
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
183935
GROUP MEDCARE
KY
05
—
215360001
—
AR
01
—
35001775
GROUP MEDICAID
KY
05
—
64333479
—
KY
Enumeration date
04/03/2006
Last updated
09/23/2016
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