Karlton James Bethea, IDC

Individual provider Active NPI Independent Duty Corpsman · Ridgecrest, CA

NPI 1700061322 · NPPES record last updated Jan 2, 2008

Key facts

NPI
1700061322
Entity type
Individual (NPI type 1)
Primary specialty
Independent Duty Corpsman 1710I1002X
Practice address
249 E Upjohn Ave
Ridgecrest, CA 93555-4175
Phone
(757) 773-1888
NPI assigned
Jan 2, 2008
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Independent Duty Corpsman 1710I1002X Yes

Addresses

Primary practice location

249 E Upjohn Ave
Ridgecrest, CA 93555-4175

Mailing address

249 E Upjohn Ave
Ridgecrest, CA 93555-4175
Phone (757) 773-1888

Other providers in Ridgecrest, CA

All providers in Ridgecrest, CA · Independent Duty Corpsman in California

Sources for this page

Verify at the official NPI Registry.