Individual
MR. MARTIN WAYNE CARR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP
Contact information
Practice address
46 JOE REYER RD, POPLARVILLE, MS 39470-6400
(601) 215-6374
Mailing address
46 JOE REYER RD, POPLARVILLE, MS 39470-6400
(601) 215-6374
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
R860912
MS
363LF0000X
Family Nurse Practitioner
Primary
R860912
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04438724
—
MS
05
—
1026522
—
LA
01
—
2813712
UHC
MS
Enumeration date
06/08/2007
Last updated
04/14/2021
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