Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Licking Valley Internal Medicine & Pediatrics PSC

Organization Internal Medicine Physician · NPI 1871626820

Licking Valley Internal Medicine & Pediatrics PSC is an Internal Medicine Physician in Carlisle, Kentucky. Licensed in Kentucky. Registered with an NPI since 2007.

Licensed in
KY
In the registry since
2007
Specialties on file
4
What do these letters mean?
PSC — Professional service corporation
A form of business registration, not a clinical qualification.

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Practice location Address checks out

254 E Main St
Carlisle, KY 40311-1156
Phone: (859) 289-6311
Fax: (859) 289-3366
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Internal Medicine Physician (primary) Taxonomy 207R00000X
Pediatrics Physician Taxonomy 208000000X
Physician Assistant Taxonomy 363A00000X · Licence PA783 (KY)
Family Nurse Practitioner Taxonomy 363LF0000X

Record details

NPI number1871626820
Entity typeOrganization (Type 2)
Organization subpartYes
Parent organizationLicking Valley Internal Medicine & Pediatrics, PSC
Authorized official Donna Martin — Office Manager · (859) 234-9611
Other names Licking Valley Im Ped-Carlisle
NPI enumeratedMarch 13, 2007
Last updated in NPPESJanuary 3, 2008
Mailing address1210 Ky Highway 36e, Suite 2a, Cynthiana, KY 41031

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