Organization
CCMH CORPORATION
Active
Other names
Carrollton Medical Associates
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SHEILA TOMLINSON (PRACTICE MANAGER)
(502) 732-3278
Entity
Organization
Contact information
Practice address
309 11TH ST, CARROLLTON, KY 41008-1435
(502) 732-3278
Mailing address
309 11TH ST, CARROLLTON, KY 41008-1435
(502) 732-3278
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000520548
ANTHEM
KY
01
—
2842260001
PASSPORT ADVANTAG
KY
01
—
50014783
PASSPORT
KY
05
—
7100020480
—
KY
Enumeration date
10/02/2007
Last updated
06/25/2020
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