Organization
CCMH CORPORATION
Active
Other names
CCMH Surgical Practice
Organization subpart
No
Provider details
NPI number
Authorized official
SHEILA TOMLINSON (DIRECTOR OF CLINICAL SERVICES)
(502) 732-3278
Entity
Organization
Contact information
Practice address
309 11TH ST, CARROLLTON, KY 41008-1435
(502) 732-3299
Mailing address
309 11TH ST, CARROLLTON, KY 41008-1435
(502) 732-3243
(502) 732-3297
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000520557
ANTHEM
KY
01
—
2842264000
PASSPORT ADVANTAGE
KY
01
—
50014767
PASSPORT
KY
05
—
7100031750
—
KY
Enumeration date
10/02/2007
Last updated
02/04/2026
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