Provider Demographics
NPI:1861440356
Name:CARAGINE, LOUIS PHILIP (MD)
Entity Type:Individual
Prefix:
First Name:LOUIS
Middle Name:PHILIP
Last Name:CARAGINE
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 843225
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64184-3225
Mailing Address - Country:US
Mailing Address - Phone:708-633-1234
Mailing Address - Fax:708-342-7100
Practice Address - Street 1:150 S MOUNT AUBURN RD
Practice Address - Street 2:SUITE 320
Practice Address - City:CAPE GIRARDEAU
Practice Address - State:MO
Practice Address - Zip Code:63703-4911
Practice Address - Country:US
Practice Address - Phone:573-331-5487
Practice Address - Fax:573-331-5488
Is Sole Proprietor?:No
Enumeration Date:2006-05-05
Last Update Date:2010-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2009027530207T00000X, 2085N0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
No2085N0700XAllopathic & Osteopathic PhysiciansRadiologyNeuroradiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
000000643993OtherANTHEM BC/BS
IL1861440356Medicaid
170727OtherHEALTH ALLIANCE
769930OtherHEALTHLINK
1861440356OtherTRIWEST
OH2546605Medicaid
MO1861440356Medicaid
MO1861440356Medicaid
MO132470033Medicare PIN
OH4153751Medicare ID - Type Unspecified