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Individual

RICHARD S CARTER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
135 W RAVINE RD, SUITE 5-B, KINGSPORT, TN 37660-3847
(423) 224-3460
(423) 224-3465
Mailing address
PO BOX 1308, KINGSPORT, TN 37662-1308
(423) 224-3460
(423) 224-3465

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
6641
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00013859
NHC CARE ADMIN.
05
005745829
VA
01
030255
ANTHEM BCBS
05
100010846
TN
01
3046935
BS OF TN
05
3158320
TN
05
3810000411
WV
01
64916059
KY MEDICAID
KY
05
8905287
NC
01
TN0100
JOHN DEERE
Enumeration date
07/20/2005
Last updated
09/11/2013
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