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Individual

RICHARD B CARTER JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
120 HOSPITAL DR, SUITE 130, JEFFERSON CITY, TN 37760-5279
(865) 475-4742
(865) 262-0100
Mailing address
1225 E WEISGARBER RD, SUITE 200, KNOXVILLE, TN 37909-2604
(865) 584-4747
(865) 584-1363

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
42180
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
37066301
MEDICARE LEGACY GROUP
TN
05
37066301
TN
01
37066303
MEDICAID LEGACY GROUP
TN
01
4132310
BCBS PIN
TN
Enumeration date
07/13/2007
Last updated
09/27/2012
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