Carrasco, Luis M

Carrasco, Luis M is an individual health care provider with primary practice located at 1233 West Poplar , Rogers AR 72756-4249. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Carrasco, Luis M can be contacted via phone (479) 636-9235.

Contact Information

Primary practice address
1233 West Poplar Rogers AR 72756-4249
Phone: (479) 636-9235
Fax: (479) 631-0374
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 33347 Kentucky
Allopathic & Osteopathic Physicians / Pediatrics 208000000X E-9613 Arkansas

Profile Details

NPI number 1306808829
LBN Legal business name Carrasco, Luis M
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 3rd, 2006
Last updated Sep 23rd, 2016 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1306808829 NPPES
Kentucky MEDICAID 64333479
Kentucky MEDICAID 215360001
Kentucky Other 183935
Kentucky Other 35001775

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