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1659377950

NPI Code Detail

MEDICARE: DR. MITCHELL CARL MD

MEDICARE: DR. MITCHELL CARL 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
1	207RH0003X	Hematology & Oncology Physician	CDR.0005430	CO
2	207RH0003X	Hematology & Oncology Physician	37722	KY

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
4	830008709	OTHER	KY	RAILROAD MEDICARE
7	P01079962	OTHER	KY	RR MEDICARE TROVER

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	023379600	OTHER	KY	FEDERAL BLACK LUNG
2	611277847C	OTHER	KY	HUMANA
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	H61953	OTHER	KY	BLUEGRASS FAMILY HEALTH
6	611277847	OTHER	KY	CHA
8	000000769615	OTHER	KY	BCBS TROVER
9	500000606	OTHER	KY	PASSPORT
10	611277847	OTHER	KY	CIGNA
11	7525437	OTHER	KY	AETNA
12	87105	OTHER	KY	COVENTRYCARES OF KENTUCKY
13	000000290035	OTHER	KY	ANTHEM BC/BS

General Provider Information

NPI Number	:	1659377950
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MITCHELL CARL MD

Provider Business Mailing Address
First Line	:	520 TECHWOOD DRIVE
Second Line	:	SUITE 100
City	:	DANVILLE
State	:	KY
Zip	:	40422-8500
Country	:	US
Telephone Number	:	859-936-9844
Fax Number	:	859-238-2206

Provider Business Practice Location Address
First Line	:	1 TRILLIUM WAY
Second Line	:	STE 302
City	:	CORBIN
State	:	KY
Zip	:	40701-8426
Country	:	US
Telephone Number	:	606-528-5000
Fax Number	:	606-528-5113

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/22/2005
Last Update Date	:	08/20/2025

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Directions to “ DR. MITCHELL CARL MD” Practice Location

Language	Start Address	Practice Location

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