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Individual

DR. JOHN A CARR

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
810 E SUNFLOWER RD STE 100A, CLEVELAND, MS 38732-2828
(662) 579-0118
(662) 846-5464
Mailing address
5943 STADIUM DR, STE 1, KALAMAZOO, MI 49009-3016
(269) 552-2836
(269) 552-2964

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
036106764
IL
208600000X
Surgery Physician
Primary
35897
MS
208600000X
Surgery Physician
4301067523
MI
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
35897
MS
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
4301067523
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
036106764
IL STATE LICENSE
IL
05
036106764
IL
01
06932023
BLUE CROSS BLUE SHIELD
IL
05
1457353658
MI
01
286294
PERSONAL CARE
IL
01
370661230
TAXPAYER ID #
IL
01
752951
HEALTHLINK
IL
01
CB3741
RR MEDICARE GROUP #
IL
01
P00320817
RR MEDICARE PIN
IL
Enumeration date
06/01/2005
Last updated
12/15/2025
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