Individual
BRIAN J CARMACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
600 MARY STREET, EVANSVILLE, IN 47747-0001
(812) 450-6800
(812) 450-6822
Mailing address
PO BOX 3407, EVANSVILLE, IN 47733-3407
(812) 450-6815
(812) 450-6822
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
01058756A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000537665
ANTHEM PIN - GATEWAY BLVD
IN
01
—
000000539314
ANTHEM PIN - MARY ST
IN
Enumeration date
06/15/2006
Last updated
03/26/2008
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