Provider Demographics
NPI:1467040345
Name:CAREATHOME MEDICAL PRACTICE KY
Entity Type:Organization
Organization Name:CAREATHOME MEDICAL PRACTICE KY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:WOOD
Authorized Official - Suffix:III
Authorized Official - Credentials:MD
Authorized Official - Phone:917-410-7931
Mailing Address - Street 1:287 PARK AVE S FL 3
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10010-4573
Mailing Address - Country:US
Mailing Address - Phone:917-410-7931
Mailing Address - Fax:
Practice Address - Street 1:287 PARK AVE S FL 3
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10010-4573
Practice Address - Country:US
Practice Address - Phone:917-410-7931
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-06
Last Update Date:2023-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty