Provider Demographics
NPI:1104403179
Name:CARPENTER, VICTORIA KAY (MD, PHD)
Entity type:Individual
Prefix:DR
First Name:VICTORIA
Middle Name:KAY
Last Name:CARPENTER
Suffix:
Gender:
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4500 CHURCHMAN AVE STE 300
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40215-1187
Mailing Address - Country:US
Mailing Address - Phone:502-977-5907
Mailing Address - Fax:
Practice Address - Street 1:4500 CHURCHMAN AVE STE 300
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40215-1187
Practice Address - Country:US
Practice Address - Phone:502-977-5907
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-25
Last Update Date:2025-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
KYTP382207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program