Individual
CAROL B PEDDICORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
250 BURKESVILLE RD, ALBANY, KY 42602-1604
(606) 387-0323
(606) 387-0310
Mailing address
250 BURKESVILLE RD, ALBANY, KY 42602-1604
(606) 387-0323
(606) 387-0310
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
25961
KY
207R00000X
Internal Medicine Physician
25961
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
64259617
—
KY
Enumeration date
08/26/2005
Last updated
09/01/2022
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