Carter, Wallace R

Carter, Wallace R is an sole proprietor health care provider with primary practice located at 825 2Nd Ave Ste B1 , Bowling Green KY 42101-1790. He recently has only one registered license in Allopathic & Osteopathic Physicians / Thoracic Surgery (Cardiothoracic Vascular Surgery), which is considered as his primary health care specialty. Carter, Wallace R can be contacted via phone (270) 796-3330.

Contact Information

Primary practice address
825 2Nd Ave Ste B1 Bowling Green KY 42101-1790
Phone: (270) 796-3330
Fax: (270) 796-3338
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Thoracic Surgery (Cardiothoracic Vascular Surgery) 208G00000X 31183 Kentucky

Profile Details

NPI number 1659370070
LBN Legal business name Carter, Wallace R
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 18th, 2005
Last updated Oct 3rd, 2023 - about 2 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 1659370070 NPPES
Kentucky MEDICAID 64311830

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