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:
Health care specialties
| Specialty | Code | License # | 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 10 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1306808829 | NPPES |
| Kentucky | MEDICAID | 64333479 | |
| Kentucky | MEDICAID | 215360001 | |
| Kentucky | Other | 183935 | |
| Kentucky | Other | 35001775 |
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