Healthcare Provider Details

I. General information

NPI: 1194850420
Provider Name (Legal Business Name): BAPTIST HEALTH MADISONVILLE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/23/2007
Last Update Date: 09/18/2023
Certification Date: 09/18/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

215 E MAIN ST
PROVIDENCE KY
42450-1261
US

IV. Provider business mailing address

900 HOSPITAL DR
MADISONVILLE KY
42431-1644
US

V. Phone/Fax

Practice location:
  • Phone: 270-667-7017
  • Fax:
Mailing address:
  • Phone: 270-825-5100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: RICHARD CARRICO
Title or Position: CFO
Credential:
Phone: 502-896-5006