Individual
DR. AMY D CARRILLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
170 N EAGLE CREEK DR STE 104, LEXINGTON, KY 40509-9087
(859) 967-5848
(859) 967-5473
Mailing address
PO BOX 936, LONDON, KY 40743-0936
(606) 330-7840
(606) 330-7825
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
03678
KY
207V00000X
Obstetrics & Gynecology Physician
DO0000001939
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1508408
—
TN
01
—
41954515
BLUE CROSS BLUE SHIELD OF TN
TN
05
—
7100314440
—
KY
05
—
7100314440 (KOHMG)
—
KY
Enumeration date
08/28/2007
Last updated
10/14/2019
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