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NPI Code Detail

MEDICARE: DR. CURTIS JAY CAROTHERS MD

MEDICARE: DR. CURTIS JAY CAROTHERS MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207RC0000XCardiovascular Disease PhysicianL6311TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
28CS231OTHERTXBLUE CROSS BLUE SHIELD

General Provider Information

NPI Number : 1346244225
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CURTIS JAY CAROTHERS MD
Provider Business Mailing Address
First Line : 2215 NASHVILLE AVE
Second Line :
City : LUBBOCK
State : TX
Zip : 79410-1105
Country : US
Telephone Number : 806-725-5844
Fax Number : 806-723-6532
Provider Business Practice Location Address
First Line : 9812 SLIDE RD
Second Line :
City : LUBBOCK
State : TX
Zip : 79424-5781
Country : US
Telephone Number : 806-725-8450
Fax Number : 806-783-9283
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/09/2005
Last Update Date : 08/30/2023

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Directions to “ DR. CURTIS JAY CAROTHERS MD” Practice Location

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