Charles Jackie Carpenter in Dothan - Surgery
Charles Jackie Carpenter - NPI 1073508404
Charles Jackie Carpenter is a Surgery in Dothan, Alabama. Charles Jackie Carpenter practices all healthcare services and medical treatments related to Surgery. The NPI Number for Charles Jackie Carpenter is 1073508404. The last update date is 2021-03-03.
Charles Jackie Carpenter's current location address is 4300 W Main St Ste 21, Dothan, Alabama. You can contact this provider via phone number 3347939564 and fax number 3346718907. The mailing address for Charles Jackie Carpenter is 4300 W Main St Ste 21, Dothan, Alabama. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Charles Jackie Carpenter |
|---|---|
| Address | 4300 W Main St Ste 21, Dothan, Alabama |
| Phone Number | 3347939564 |
| Fax Number | 3346718907 |
| Sole Proprietor | Y |
| Credentials | MD |
NPI Number Detail
| NPI Number | 1073508404 |
|---|---|
| Provider Enumeration Date | 2005-09-12 |
| Last Updated Date | 2021-03-03 |
Provider Mailing Address Detail
| Address | 4300 W Main St Ste 21 |
|---|---|
| City | Dothan |
| State | Alabama (AL) |
| Post Code | 363051058 |
| Phone Number | 3347939564 |
| Fax Number | 3346718907 |
Provider's Primary Taxonomy Detail
| Speciality | Surgery |
|---|---|
| Taxonomy | 208600000X |
| Licence No | 17706 |
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Definition: A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 32574 | AL | -- | |
| 1073508404 | NPI | ||
| 00801743A | GA | -- |
Post Comment/ Review Below
What is the unique 10-digit identifier code assigned to Charles Jackie Carpenter by the Centers for Medicare & Medicaid Services?
The Charles Jackie Carpenter has been issued the NPI (National Provider Identifier) 1073508404 by the CMS (Centers for Medicare & Medicaid Services), which serves as a unique identification number for healthcare providers.
Could you share the physical location details of Charles Jackie Carpenter?
The Charles Jackie Carpenter is situated at 4300 W Main St Ste 21, in the city of Dothan, state of AL, with the zip code 363051058.
What is Charles Jackie Carpenter's specialized field of practice, and what is the corresponding taxonomy classification code?
The Charles Jackie Carpenter's area of specialization is Surgery, and the corresponding taxonomy code that categorizes this field of practice is 208600000X.
On what date did the Centers for Medicare & Medicaid Services originally issue the 1073508404 to Charles Jackie Carpenter?
The Centers for Medicare & Medicaid Services originally issued the 1073508404 to Charles Jackie Carpenter on 2005-09-12.
As of what date were the Charles Jackie Carpenter's details last updated?
The information pertaining to the Charles Jackie Carpenter, including its address, specialty, and other details, was most recently updated on 2021-03-03.
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