| Doctor Name: | CARL THEODORE OPDERBECK |
| NPI Number: | 1316194954 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MD |
| License Number: | 196220 |
| Business Practice Address: | Route 7 And Route 12 Fort Defiance Indian Hospital Fort Defiance, AZ - 865040649 |
| Business Phone Number: | 9287298020 |
| Business Fax Number: | 8287298794 |
| Mailing Address: | 364 Log Cabin Ln, UNION MILLS |
| State: | NC |
| Postal Code: | 281679004 |
| Phone Number: | 8282880012 |
| Fax Number: | 8282880012 |
| NPI Enumeration Date: | 08/26/2008 |
| NPI Last Update Date: | 08/26/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 207V00000X |
| License Number: | 196220 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Obstetrics & Gynecology |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |