Individual
DR. JOHN TIMOTHY CARMACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD, MPH
Contact information
Practice address
618 HOSPITAL RD, TAPPAHANNOCK, VA 22560-5000
(804) 443-6297
Mailing address
3450 MAIDENS RD, POWHATAN, VA 23139-4015
(804) 928-8167
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
0101045525
VA
207P00000X
Emergency Medicine Physician
MD.09541R
LA
207Q00000X
Family Medicine Physician
0101045525
VA
207Q00000X
Family Medicine Physician
Primary
30744
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
005639301
—
VA
05
—
005829623
—
VA
05
—
1023034972
—
VA
Enumeration date
07/14/2006
Last updated
05/15/2023
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