Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223S0112X | Oral and Maxillofacial Surgeon | 10249 | KY |
N | 204E00000X | Oral & Maxillofacial Surgeon | 10249 | KY |
NPI | 1144607920 |
---|---|
Provider Name | Dr. Austin Ray Carey |
First Address | Louisville, KY 40207-4612 |
Second Address | Louisville, KY 40207-4612 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/04/2015 |
Last Update Date | 09/07/2019 |