Provider Demographics
NPI:1326027582
Name:ANDERSON, CARLETON T (MD)
Entity type:Individual
Prefix:DR
First Name:CARLETON
Middle Name:T
Last Name:ANDERSON
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:14275 MIDWAY RD
Mailing Address - Street 2:STE 400
Mailing Address - City:ADDISON
Mailing Address - State:TX
Mailing Address - Zip Code:75001-3614
Mailing Address - Country:US
Mailing Address - Phone:214-932-8029
Mailing Address - Fax:610-271-4245
Practice Address - Street 1:2620 WILHITE DRIVE
Practice Address - Street 2:SUITE 213
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40503-3385
Practice Address - Country:US
Practice Address - Phone:317-275-8072
Practice Address - Fax:317-275-8124
Is Sole Proprietor?:No
Enumeration Date:2006-01-16
Last Update Date:2014-11-26
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Provider Licenses
StateLicense IDTaxonomies
KY30012207ZC0500X, 207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
No207ZC0500XAllopathic & Osteopathic PhysiciansPathologyCytopathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY1069836OtherMCD HMO
WV1841763-000Medicaid
KY64300122Medicaid
KY000000363563OtherBCBS
KY220019572OtherTRAVELERS
OH2386529Medicaid
2434822000OtherPASSPORT ADVANTAGE
0039906Medicare PIN
KY220019572OtherTRAVELERS