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NPI Code Detail

MEDICARE: DR. CARL F. CONWELL MD

MEDICARE: DR. CARL F. CONWELL 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
1207Q00000XFamily Medicine Physician01036108IN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2153868OTHERINRURAL HEALTH CLINIC
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1952304123
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CARL F. CONWELL MD
Provider Business Mailing Address
First Line : PO BOX 230
Second Line :
City : SULLIVAN
State : IN
Zip : 47882-0230
Country : US
Telephone Number : 812-268-3318
Fax Number :
Provider Business Practice Location Address
First Line : 2229 MARY SHERMAN DR
Second Line :
City : SULLIVAN
State : IN
Zip : 47882-7633
Country : US
Telephone Number : 812-268-3318
Fax Number : 812-268-4017
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/23/2005
Last Update Date : 04/27/2021

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Directions to “ DR. CARL F. CONWELL MD” Practice Location

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