Individual
MR. CARL H ROSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6373 BRANDENBURG RD, LEITCHFIELD, KY 42754-7534
(270) 215-1036
(270) 844-4654
Mailing address
6373 BRANDENBURG RD, LEITCHFIELD, KY 42754-7534
(270) 215-1036
(270) 844-4654
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
30020
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000476600
ANTHEM BLUE CROSS AND BLUE SHIELD
KY
01
—
000000612653
ANTHEMBCBS
KY
01
—
10810680
CAQH
KY
01
—
50023040
PASSPORT HEALTH
KY
05
—
64300205
—
KY
Enumeration date
09/09/2005
Last updated
09/21/2009
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