Individual
KENNETH CARTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1405 N STATE ST, SUITE 200, JACKSON, MS 39202-1642
(601) 354-4327
(601) 360-0822
Mailing address
1405 NORTH STATE STREET, SUITE 200, JACKSON, MS 39202
(601) 354-4327
(601) 360-0822
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
06900
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0115577
—
MS
Enumeration date
10/10/2006
Last updated
07/08/2007
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