Individual
PETER E CARR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5979 DESERT STORM AVE, FORT CAMPBELL, KY 42223-5514
(931) 561-6034
Mailing address
5979 DESERT STORM AVE, FORT CAMPBELL, KY 42223-5514
(931) 561-6034
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
59259
KY
208D00000X
General Practice Physician
32007
NE
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
02/25/2018
Last updated
10/31/2024
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