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Organization
CARTER & RICHARDS, P.A.
Active
Organization
CARTER & RICHARDS, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STEPHEN J CARTER M.D. (OWNER PHYSICIAN)
(208) 529-5909
Entity
Organization
Contact information
Practice address
2001 S WOODRUFF AVE, SUITE 3, IDAHO FALLS, ID 83404-6374
(208) 529-5909
(208) 529-5990
Mailing address
2001 S WOODRUFF AVE, SUITE 3, IDAHO FALLS, ID 83404-6374
(208) 529-5909
(208) 529-5990
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
M4157
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010006486
BLUE SHIELD
ID
01
—
84640
BLUE CROSS
ID
Enumeration date
01/17/2007
Last updated
08/22/2020
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