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Individual

MATTHEW LECARPENTIER BAKER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
217 S 3RD ST, DANVILLE, KY 40422-1823
(859) 236-3726
(859) 236-3019
Mailing address
223 EXECUTIVE PARK, LOUISVILLE, KY 40207-4202
(502) 907-0356
(502) 919-9780

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
2013-01259
NC
207L00000X
Anesthesiology Physician
Primary
47076
KY
207LP2900X
Pain Medicine (Anesthesiology) Physician
47076
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000001136574
ANTHEM PROVIDER ID
KY
01
1760616817
VIRGINIA MEDICAID
NC
05
1760616817
NC
01
179RK
BCBS
NC
01
275928
MEDCOST
NC
01
3650736
UNITED HEALTHCARE
NC
01
5996966
AETNA
NC
05
7100293780
KY
01
P01270450
RAILROAD MEDICARE
NC
Enumeration date
05/04/2009
Last updated
01/15/2021
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