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Individual
MR. JEFFREY WAYNE CARTER
Active
Individual
MR. JEFFREY WAYNE CARTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
972770
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
972770
BUSINESS ID
MS
Enumeration date
12/13/2010
Last updated
12/13/2010
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