Individual
DR. DOUGLAS RAY CARPENTER JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
100 LANTANA ROAD, SUITE 202, CROSSVILLE, TN 38555-1903
(931) 484-5141
(931) 484-5620
Mailing address
100 LANTANA ROAD, SUITE 202, CROSSVILLE, TN 38555-1903
(931) 484-5141
(931) 484-5620
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD17544
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080059056
RAILROAD MEDICARE
—
01
—
3072543
BLUE CROSS
TN
05
—
3084713
—
TN
Enumeration date
09/07/2006
Last updated
06/07/2021
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