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Individual

MR. GARY D CARR

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
11020 STATE ROUTE 250, LAWRENCEVILLE, IL 62439-3379
(618) 943-2609
(618) 943-6409
Mailing address
PO BOX 516, LAWRENCEVILLE, IL 62439
(618) 943-2609
(618) 943-6409

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
036058645
IL
207Q00000X
Family Medicine Physician
Primary
036058645
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
003230
HEALTH ALLIANCE INS
IL
05
036058645
IL
01
131890
HEALTHLINK INS
IL
01
1729885
FIRST HEALTH
05
376006178007
IL
01
5132004
BCBS
IL
01
838915
UNITED HEALTHCARE
Enumeration date
07/10/2006
Last updated
09/09/2019
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