Provider Demographics
NPI:1417905399
Name:NECHTMAN, CARL M JR (MD)
Entity Type:Individual
Prefix:DR
First Name:CARL
Middle Name:M
Last Name:NECHTMAN
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 950248
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40295-0248
Mailing Address - Country:US
Mailing Address - Phone:502-253-4900
Mailing Address - Fax:502-489-5750
Practice Address - Street 1:11 HOSPITAL WAY
Practice Address - Street 2:STE A
Practice Address - City:BLAIRSVILLE
Practice Address - State:GA
Practice Address - Zip Code:30512-3144
Practice Address - Country:US
Practice Address - Phone:706-439-6875
Practice Address - Fax:706-439-6877
Is Sole Proprietor?:No
Enumeration Date:2006-05-04
Last Update Date:2019-05-01
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
KY25260207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL051529507OtherBCBS
ALC78518Medicare UPIN
AL000034474Medicare ID - Type Unspecified
AL000034474Medicaid