Provider Demographics
NPI:1811457872
Name:CARBONE, LAUREL PACE (MD)
Entity type:Individual
Prefix:
First Name:LAUREL
Middle Name:PACE
Last Name:CARBONE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:LAUREL
Other - Middle Name:
Other - Last Name:CARBONE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:6420 DUTCHMANS PKWY STE 190
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40205-3313
Mailing Address - Country:US
Mailing Address - Phone:502-588-7660
Mailing Address - Fax:
Practice Address - Street 1:6420 DUTCHMANS PKWY STE 190
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40205-3313
Practice Address - Country:US
Practice Address - Phone:500-258-8766
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-24
Last Update Date:2023-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY58269207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology