Provider Demographics
NPI:1346531720
Name:CARFIELD, DUSTIN KENT (MD)
Entity Type:Individual
Prefix:
First Name:DUSTIN
Middle Name:KENT
Last Name:CARFIELD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 REID PKWY
Mailing Address - Street 2:MEDICAL STAFF SERVICES
Mailing Address - City:RICHMOND
Mailing Address - State:IN
Mailing Address - Zip Code:47374-1157
Mailing Address - Country:US
Mailing Address - Phone:765-935-8747
Mailing Address - Fax:765-983-3008
Practice Address - Street 1:1100 REID PKWY
Practice Address - Street 2:ANESTHESIA DEPARTMENT
Practice Address - City:RICHMOND
Practice Address - State:IN
Practice Address - Zip Code:47374-1157
Practice Address - Country:US
Practice Address - Phone:765-935-8747
Practice Address - Fax:765-983-3008
Is Sole Proprietor?:No
Enumeration Date:2011-04-20
Last Update Date:2021-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01072377A207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN201107510Medicaid
IN000000944643OtherANTHEM (REID PHYSICIAN ASSOCIATES, INC.)
OH0140191Medicaid
IN000000944643OtherANTHEM (REID PHYSICIAN ASSOCIATES, INC.)