Individual
RUSSELL W CARTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
2605 KENTUCKY AVE, SUITE 202, PADUCAH, KY 42003-3800
(270) 415-4690
(270) 415-4691
Mailing address
2605 KENTUCKY AVE, SUITE 306, PADUCAH, KY 42003-3800
(270) 415-4690
(270) 415-4691
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
02476
KY
207RG0100X
Gastroenterology Physician
036102415
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
64024763
—
KY
Enumeration date
03/14/2006
Last updated
12/07/2020
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