Provider Demographics
NPI:1902237399
Name:BAPTIST HEALTH MADISONVILLE INC.
Entity type:Organization
Organization Name:BAPTIST HEALTH MADISONVILLE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:CARRICO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:502-896-5006
Mailing Address - Street 1:900 HOSPITAL DR
Mailing Address - Street 2:
Mailing Address - City:MADISONVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:42431-1644
Mailing Address - Country:US
Mailing Address - Phone:270-825-5100
Mailing Address - Fax:
Practice Address - Street 1:44 MCCOY AVE
Practice Address - Street 2:
Practice Address - City:MADISONVILLE
Practice Address - State:KY
Practice Address - Zip Code:42431-2867
Practice Address - Country:US
Practice Address - Phone:270-821-0677
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-10
Last Update Date:2023-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
207X00000X, 207X00000X
KY207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY8625Medicare PIN