Provider Demographics
NPI:1568468163
Name:ASELTON, CARL K (MD)
Entity Type:Individual
Prefix:
First Name:CARL
Middle Name:K
Last Name:ASELTON
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:PO BOX 5
Mailing Address - Street 2:
Mailing Address - City:MILBRIDGE
Mailing Address - State:ME
Mailing Address - Zip Code:04658-0005
Mailing Address - Country:US
Mailing Address - Phone:207-546-2391
Mailing Address - Fax:
Practice Address - Street 1:24 SCHOOL ST
Practice Address - Street 2:
Practice Address - City:MILBRIDGE
Practice Address - State:ME
Practice Address - Zip Code:04658-3542
Practice Address - Country:US
Practice Address - Phone:207-546-2391
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-06-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME02417207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MED03629Medicare UPIN
ME208507Medicare ID - Type Unspecified