Organization
MARK P CARUSO MD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
REBECCA L STEPHENS (OFFICE MANAGER)
(606) 789-4949
Entity
Organization
Contact information
Practice address
713 BROADWAY ST, SUITE 203, PAINTSVILLE, KY 41240-1465
(606) 789-4949
Mailing address
713 BROADWAY ST, SUITE 203, PAINTSVILLE, KY 41240-1465
(606) 789-4949
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
26513
KY
363A00000X
Physician Assistant
PA804
KY
Other
Enumeration date
04/01/2014
Last updated
07/21/2022
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