Individual
MARY CAROLYN HOUSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2201 LEXINGTON AVE, ASHLAND, KY 41101
(606) 324-1234
Mailing address
PO BOX 2379, ASHLAND, KY 41105-2379
(606) 408-6200
(606) 408-6612
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
51222
KY
207R00000X
Internal Medicine Physician
BP10052625
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100536720
—
KY
Enumeration date
05/05/2015
Last updated
08/24/2018
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