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General NPI Number Information
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NPI Number | 1699767327
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Entity Type | Organization
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Legal Business Name | MEDICAL CENTER INTERNISTS, PSC
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Dates
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Enumeration Date | 08/18/2005
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Last Update Date | 08/31/2012
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Provider Practice Location Address
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Address Line | 225 ABRAHAM FLEXNER WAY SUITE 304
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City | LOUISVILLE
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State | KY
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Zip | 40202-1846
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Country | US
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Telephone | 502-585-1200
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Fax | 502-585-1207
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Provider Business Mailing Address
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Address Line | 225 ABRAHAM FLEXNER WAY SUITE 304
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City | LOUISVILLE
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State | KY
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Zip | 40202-1846
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Country | US
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Telephone | 502-585-1200
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Fax | 502-585-1207
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Authorized Official
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Title or Position | MEDICAL DOCTOR
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Name | DR. KEITH B CARTER
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Credential | M.D.
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Telephone | 502-585-1200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 24559 25176 32796
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License Number State | KY
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