Provider Demographics
NPI:1154476331
Name:CAROLE KIPHART BAYS PSC
Entity Type:Organization
Organization Name:CAROLE KIPHART BAYS PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RADIOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:CAROLE
Authorized Official - Middle Name:
Authorized Official - Last Name:KIPHART-BAYS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:606-573-2398
Mailing Address - Street 1:PO BOX 360
Mailing Address - Street 2:
Mailing Address - City:GRAYS KNOB
Mailing Address - State:KY
Mailing Address - Zip Code:40829-0360
Mailing Address - Country:US
Mailing Address - Phone:606-573-2398
Mailing Address - Fax:606-574-9995
Practice Address - Street 1:81 BALL PARK RD
Practice Address - Street 2:
Practice Address - City:HARLAN
Practice Address - State:KY
Practice Address - Zip Code:40831-1701
Practice Address - Country:US
Practice Address - Phone:606-573-8100
Practice Address - Fax:606-574-9995
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY305032085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64305030Medicaid
KY64305030Medicaid
KY9039Medicare ID - Type Unspecified