Organization Name: | MIKE CARTER MD PLLC |
NPI Number: | 1659589000 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | WILLIAM MICHAEL CARTER (OWNER) |
Mailing Address: | 606 N Main St Tompkinsville |
State: | KY US |
Postal Code: | 421671128 |
Phone Number: | 2704876161 |
Fax Number: | 2704878009 |
NPI Enumeration Date: | 05/18/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QP2300X |
License Number: | 22770 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | KY |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Primary Care |
Taxonomy Definition: |